Tang J B
Department of Orthopedics, Affiliated Hospital, Nantong Medical College.
Chin Med J (Engl). 1992 Sep;105(9):758-65.
134 fractures of the distal radius in 132 patients are reviewed to determine the incidence and influencing factors of coexisting carpal in stability. By measurement and analysis of the changes in carpal angles and joint spaces, carpal instability was discovered in 41 fractures, an incidence of 30.6%. Six patterns of instability were observed, including dorsal intercalated segmental instability (DISI), scapholunate dissociation, dorsal and palmar translocations, volar intercalated segmental instability (VISI) and ulnar carpal translocation. Accompanying carpal instability was more often seen in elderly patients. To a certain extent, the patterns of instability were related to the type of fracture and palmar tilt angle (PTA) values. DISI was often seen in fractures with PTA smaller than -15 degrees, while scapholunate dissociation was seen in fractures with PTA between -5 degrees and -20 degrees. The possible pathomechanics of the accompanying carpal instability were deduced based on the kinematics and influencing factors indicated in this study.
回顾132例患者的134例桡骨远端骨折，以确定并存腕关节不稳定的发生率及影响因素。通过测量和分析腕骨角度及关节间隙的变化，发现41例骨折存在腕关节不稳定，发生率为30.6%。观察到六种不稳定模式，包括背侧插入节段性不稳定（DISI）、舟月骨分离、背侧和掌侧移位、掌侧插入节段性不稳定（VISI）和尺侧腕骨移位。并存腕关节不稳定在老年患者中更常见。在一定程度上，不稳定模式与骨折类型和掌倾角（PTA）值有关。PTA小于-15度的骨折常出现DISI，而PTA在-5度至-20度之间的骨折出现舟月骨分离。基于本研究所示的运动学和影响因素，推断了并存腕关节不稳定的可能发病机制。
