Schneiders W, Amlang M, Rammelt S, Zwipp H
Klinik und Poliklinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinikum Carl Gustav Carus, Dresden.
Unfallchirurg. 2005 Sep;108(9):715-20. doi: 10.1007/s00113-005-0947-7.
Early diagnosis and appropriate treatment of acute scapholunate dissociation (SLD) is crucial for obtaining a favorable result in fractures of the distal radius. The aim of this study was to determine the incidence of acute SLD in a prospective study and to differentiate this entity from chronic SLD.
A total of 120 patients with unilateral distal radius fractures were prospectively evaluated for SLD. Stress radiographs were obtained for all patients on the injured side after fixation of the distal radius fractures. In cases of SLD the unaffected side was examined to rule out chronic, bilateral SLD.
Acute SLD was detected in 13 patients (11%), 11 (9.1%) of whom had stage 3 injury. Chronic SLD with bilateral asymptomatic instability was seen in three patients (2.5%).
When treating fractures of the distal radius, acute SLD has to be ruled out and to be discriminated from chronic SLD. While acute SLD requires appropriate treatment, immediate treatment of chronic SLD is not indicated.
早期诊断和恰当治疗急性舟月骨分离（SLD）对于桡骨远端骨折获得良好疗效至关重要。本研究的目的是在一项前瞻性研究中确定急性SLD的发生率，并将该实体与慢性SLD区分开来。
对120例单侧桡骨远端骨折患者进行前瞻性SLD评估。在桡骨远端骨折固定后，对所有患者受伤侧进行应力位X线片检查。对于SLD病例，检查未受伤侧以排除慢性双侧SLD。
13例患者（11%）检测到急性SLD，其中11例（9.1%）为3期损伤。3例患者（2.5%）出现双侧无症状不稳定的慢性SLD。
在治疗桡骨远端骨折时，必须排除急性SLD并将其与慢性SLD区分开来。急性SLD需要恰当治疗，而慢性SLD则无需立即治疗。
