Flinkkilä T, Raatikainen T, Kaarela O, Hämäläinen M
Oulu University Hospital, Department of Surgery, Finland.
Arch Orthop Trauma Surg. 2000;120(1-2):23-6. doi: 10.1007/pl00021237.
Forty-five patients were reviewed on average 5.7 years after corrective osteotomy for symptomatic distal radius malunion. Restoration of anatomy and function was assessed compared with the contralateral wrist. It was found that osteotomy of the distal radius alone did not completely restore normal anatomy and relieve symptoms, and in several cases a second operation was needed. Osteoarthritic changes in the radiocarpal and radioulnar joints were common, and they correlated with restriction in range of motion, but not with pain. Range of motion and grip power were reduced compared to the unaffected hand, but only loss of supination and ulnar deviation correlated with an unsatisfactory subjective result. The result was good or satisfactory in 33 of the 45 patients. We conclude that reconstructive procedures in patients with distal radius malunion may not completely restore normal function, and every effort should therefore be made to prevent malunion in the treatment of distal radius fractures.
对45例有症状的桡骨远端畸形愈合患者进行了平均5.7年的随访，评估了与对侧手腕相比解剖结构和功能的恢复情况。结果发现，单纯的桡骨远端截骨术并不能完全恢复正常解剖结构和缓解症状，在一些病例中需要进行二次手术。桡腕关节和桡尺关节的骨关节炎改变很常见，它们与活动范围受限相关，但与疼痛无关。与未受影响的手相比，活动范围和握力降低，但只有旋后和尺偏的丧失与主观结果不满意相关。45例患者中有33例结果良好或满意。我们得出结论，桡骨远端畸形愈合患者的重建手术可能无法完全恢复正常功能，因此在桡骨远端骨折的治疗中应尽一切努力预防畸形愈合。
