Missakian M L, Cooney W P, Amadio P C, Glidewell H L
Department of Orthopedics, Mayo Clinic, Rochester, MN 55905.
J Hand Surg Am. 1992 Jul;17(4):745-55. doi: 10.1016/0363-5023(92)90327-l.
From a series of 650 dorsally angulated fractures of the distal radius, 32 intra-articular fractures were treated by open reduction and internal fixation. The 32 fractures were classified according to the Frykman criteria as type VII (5) or type VIII (27). On the basis of the location of intra-articular involvement, the fractures were further subdivided into Mayo type II (4), type III (18), and type IV (10). Results were analyzed by the methods of Gartland and Werley (functional) and Lidström (radiographic). After open reduction and internal fixation, 90% of the patients had satisfactory results on the basis of the subjective criteria of minimal deformity, absence of pain, and good strength. Objective assessment demonstrated that the patients had 80% of normal motion and 73% of normal grip strength at a minimum of 2 years after the operation. On the basis of radiographic and functional evaluation, results were good to excellent in 87%. When intra-articular step-off exceeded 2 mm or the radius was shortened more than 5 mm, the results were only fair and posttraumatic arthritis was evident.
在650例桡骨远端背侧成角骨折中，32例关节内骨折采用切开复位内固定治疗。这32例骨折根据Frykman标准分为Ⅶ型（5例）或Ⅷ型（27例）。根据关节内受累部位，骨折进一步细分为MayoⅡ型（4例）、Ⅲ型（18例）和Ⅳ型（10例）。采用Gartland和Werley（功能）以及Lidström（影像学）方法分析结果。切开复位内固定后，基于畸形最小、无疼痛和力量良好的主观标准，90%的患者结果满意。客观评估表明，术后至少2年时，患者的活动度为正常的80%，握力为正常的73%。根据影像学和功能评估，87%的结果为良好至优秀。当关节内台阶超过2mm或桡骨缩短超过5mm时，结果仅为一般，创伤后关节炎明显。
