Sturzenegger M, Büchler U
Division of Hand Surgery, University of Bern, Inselspital, Switzerland.
Ann Chir Main Memb Super. 1991;10(3):207-16. doi: 10.1016/s0753-9053(05)80285-6.
Painful radiocarpal arthritis following comminuted fractures of the distal radius may be treated either by total wrist fusion or by procedures which preserve movement. The authors have reviewed 15 patients with such fractures who have undergone radio-scapho-lunate partial arthrodesis. They report the results with an average follow-up of 23.8 months. Pain was abolished in 7 patients and resolved virtually completely in 4 cases. Restored grip strength averaged 49% of the contralateral side. There was considerable limitation of postoperative range of motion which was restricted to an oblique plane extending dorso-radial to palmar-ulnar. Most patients did not report this as a problem. Two cases of non-union were reported as well as a 35.7% incidence of secondary degenerative change in the midcarpal joint. This feature casts doubt on the predictability of outcome of this procedure.
桡骨远端粉碎性骨折后出现的疼痛性桡腕关节炎,可通过全腕关节融合术或保留活动的手术进行治疗。作者回顾了15例接受桡舟月部分关节固定术治疗此类骨折的患者。他们报告了平均随访23.8个月的结果。7例患者疼痛消失,4例患者疼痛几乎完全缓解。恢复后的握力平均为对侧的49%。术后活动范围有相当大的限制,仅限于从背桡向掌尺延伸的斜平面。大多数患者并未将此视为问题。报告了2例骨不连以及腕中关节继发性退变改变的发生率为35.7%。这一特征使人对该手术结果的可预测性产生怀疑。