Rettig M E, Raskin K B
Department of Orthopaedic Surgery, New York University Medical Center/Hospital for Joint Diseases, New York, NY 10016, USA.
J Hand Surg Am. 2001 Mar;26(2):228-35. doi: 10.1053/jhsu.2001.21523.
Forty patients with Galeazzi fracture-dislocations were treated with open reduction and internal fixation of the radial shaft fracture. Intraoperative distal radioulnar joint (DRUJ) instability after anatomic reduction was managed with supplemental wire transfixion of the DRUJ (10 patients) or open reduction and triangular fibrocartilage complex repair (3 patients). Two patterns of fracture-dislocation were identified based on the location of the radial shaft fracture. Twenty-two type I fractures were in the distal third of the radius within 7.5 cm of the midarticular surface of the distal radius; 12 of these cases were associated with intraoperative DRUJ instability. Eighteen type II fractures were in the middle third of the radial shaft more than 7.5 cm from the midarticular surface of the distal radius. Only one of these fractures had intraoperative DRUJ instability after open reduction and internal fixation of the radial shaft fracture. A high index of suspicion, early recognition, and acute treatment of DRUJ instability will avoid chronic problems in this complex injury.
40例盖氏骨折脱位患者接受了桡骨干骨折切开复位内固定治疗。解剖复位后术中出现下尺桡关节（DRUJ）不稳定的患者，采用DRUJ补充钢丝固定（10例）或切开复位及三角纤维软骨复合体修复（3例）进行处理。根据桡骨干骨折的位置确定了两种骨折脱位类型。22例I型骨折位于桡骨远端距桡骨远端关节面中点7.5 cm范围内的远端三分之一处；其中12例与术中DRUJ不稳定相关。18例II型骨折位于桡骨干中部距桡骨远端关节面中点超过7.5 cm处。在桡骨干骨折切开复位内固定后，这些骨折中只有1例出现术中DRUJ不稳定。对DRUJ不稳定保持高度怀疑、早期识别并进行积极治疗，将避免这种复杂损伤出现慢性问题。
