桡骨远端骨折对腕关节稳定性的影响
费俊梁;王黎明;蒋纯志
【期刊名称】《中华外科杂志》 【年(卷),期】2008(046)001
【摘要】目的 研究各型桡骨远端骨折导致的腕关节不稳手术与非手术治疗的临床疗效及对腕关节稳定性的影响.方法 1999年1月至2006年9月桡骨远端骨折患者200例,采用AO分型,标准腕关节正侧位片测量桡月角、舟月角、桡骨远端长度、关节面落差、舟月近远侧间距.手法复位石膏外固定患者和桡骨远端切开复位内固定治疗患者进行比较,采用改良Gartland和Werley评分标准评定腕关节功能恢复情况,并进行统计学分析.结果 临床平均随访时间5年2个月,结果发现舟月分离、背屈不稳、掌屈不稳、背侧偏移和掌侧偏移5种腕关节不稳;优良率为78%.桡骨远端长度缩短≥2.5 mm与＜2.5 mm的桡骨远端骨折患者腕关节不稳发生率比较,Fisher确切概率P＜0.01;桡骨远端关节面的落差≥2 mm与＜2 mm的桡骨远端骨折患者腕关节不稳发生率比较,Fisher确切概率P＜0.01.结论 桡骨远端骨折对桡腕关节面、桡骨远端长度、掌倾角的恢复与患者的疗效密切相关,腕关节的稳定性依赖于骨性结构和周围韧带的完整性,腕关节不稳将严重影响腕关节功能.对于严重关节内的骨折应手术治疗解剖复位.%Objectives To investigate the influence of wrist joint stability of patients with diversified fracture of the distal radius,and to find out the difference of the clinical effect between the patients with surgical treatment and non-surgical treatment.Methods From January 1999 to September 2006 a total of 200 cases with the fracture of the distal
radius were reviewed according to the AO classification,the radiolunate angle,scapholunate angle,palmar tilt angle and the length of the radial shorting and step-off of the articular surface were measured by the standard X-ray.Gartland and Werley as modified by Sarmiento evaluation system was used,and the results were statistically analyzed.Results The average follow-up period was 5 years and 2 months.The
follow-ups
revealed
5
types
of
carpal segment
instability:scapholunate dissociation,volar intercalated
instability,dorsal intercalated segment instability and palmar or dorsal shift of the carpus.Functional results were excellent and good in 78% of the total patients.The increasing of the length of the radial shorting and step-off of the articular surface was found to be associated with greater risk of carpal instability.Conclusions Based on the results of the study,wrist articular surface and radial shortening and palmar tilt angle should be considered as the most important factors of the healing effect after the fracture of the distal radius.Wrist ioint stability depends on the structure of the bone and ligament around wrist joint.Carpal instability wound leads to significantly effect on the wrist.And surgery was necessary to severe interartical fracture of the distal radius. 【总页数】4页(34-37)
【关键词】桡骨骨折;腕关节;关节不稳定性;桡腕关节面;桡骨远端长度 【作者】费俊梁;王黎明;蒋纯志
【作者单位】210006,南京医科大学附属南京第一医院骨科;210006,南京医科大学附属南京第一医院骨科;210006,南京医科大学附属南京第一医院骨科 【正文语种】中文 【中图分类】R6 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_chinese-journal-surgery_thesis/0201234929991.html 【相关文献】
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桡骨远端骨折对腕关节稳定性的影响
