Bae Donald S, Waters Peter M
Department of Orthopaedic Surgery, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
Hand Clin. 2006 Feb;22(1):43-53. doi: 10.1016/j.hcl.2005.09.002.
Management of distal radius fractures is guided by the pattern and location of injury, degree of deformity, and expectations of bony remodeling based on the amount of remaining skeletal growth.Indications for surgical treatment include unstable or irreducible fractures, open fractures, floating elbow injuries, and neurovascular or soft-tissue compromise precluding cast immobilization. Patients and families should be counseled regarding the potential for post-traumatic distal radial growth arrest following physeal fractures. In these cases, epiphysiodeses, ulnar shortening osteotomies, or corrective radial osteotomies may be performed, depending on the pattern of arrest,degree of deformity, and remaining skeletal growth.TFCC tears may be the source of ulnar-sided wrist pain in children and adolescents, though symptoms and physical examination findings maybe subtle. Patients who have persistent pain and functional limitations despite activity modification and therapy are candidates for surgical treatment. Appropriate repair of peripheral TFCC tears with correction of concomitant wrist pathology restores normal wrist anatomy, alleviates pain, and allows for return to functional activities.
桡骨远端骨折的治疗取决于损伤的类型和部位、畸形程度以及根据剩余骨骼生长量对骨重塑的预期。手术治疗的指征包括不稳定或无法复位的骨折、开放性骨折、浮动肘关节损伤以及因神经血管或软组织损伤而无法进行石膏固定的情况。应向患者及其家属咨询骨骺骨折后创伤性桡骨远端生长停滞的可能性。在这些情况下，可根据生长停滞的类型、畸形程度和剩余骨骼生长情况进行骨骺阻滞术、尺骨缩短截骨术或桡骨矫正截骨术。TFCC撕裂可能是儿童和青少年尺侧腕部疼痛的原因，尽管症状和体格检查结果可能不明显。尽管进行了活动调整和治疗仍有持续疼痛和功能受限的患者是手术治疗的候选者。对周围TFCC撕裂进行适当修复并纠正伴随的腕部病变可恢复正常的腕部解剖结构，减轻疼痛，并允许恢复功能活动。
