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科雷氏骨折后尺骨短缩截骨术

Ulnar shortening osteotomy after Colles fracture.

作者信息

Petersen Kirstin, Breddam Marianne, Jørgsholm Peter, Schrøder Henrik

机构信息

Department of Hand Surgery, Odense University Hospital, Denmark.

出版信息

Scand J Plast Reconstr Surg Hand Surg. 2005;39(3):170-7. doi: 10.1080/02844310410004919.

Abstract

Ulnar shortening is well accepted in the treatment of ulnar abutment but less so in patients with a shortened radius and ulnar-sided wrist pain as a result of a Colles fracture. Sixteen patients with pain and reduced range of movement (ROM) and a median preoperative ulnar positive variance of 5 mm (range 0.5-11) had 17 osteotomies. Nine were male and seven female with a median age of 35 (range 15-55) years were operated on. Fifteen patients with 16 osteotomies could be reached for follow-up. The ulna was shortened by a median of 4.5 mm (range 3-12). The median pain score was reduced by 3 points (range 0-5). Postoperative ROM was improved in nine, unchanged in six, and reduced in one wrists. There were four complications: one re-fracture, two transient paraesthesiae, and one superficial infection. Seven of the patients regarded the result as excellent, six as good, three as fair, and none regarded it as poor. Thirteen of the 16 would have chosen the operation again, three would not.

摘要

尺骨短缩术在治疗尺骨撞击症方面已被广泛接受,但在因科雷氏骨折导致桡骨短缩和尺侧腕部疼痛的患者中应用较少。16例伴有疼痛和活动范围(ROM)减小、术前尺骨正变异中位数为5mm(范围0.5 - 11mm)的患者接受了17次截骨手术。接受手术的患者中,9例为男性,7例为女性,年龄中位数为35岁(范围15 - 55岁)。15例接受16次截骨手术的患者获得了随访。尺骨短缩的中位数为4.5mm(范围3 - 12mm)。疼痛评分中位数降低了3分(范围0 - 5分)。9例患者术后ROM改善,6例无变化,1例腕部ROM减小。出现了4例并发症:1例再次骨折、2例短暂性感觉异常和1例浅表感染。7例患者认为结果优秀,6例认为良好,3例认为一般,无人认为结果差。16例患者中有13例表示会再次选择该手术,3例则不会。

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