Lozano-Calderón S A, Brouwer K M, Doornberg J N, Goslings J Carel, Kloen P, Jupiter J B
Harvard Medical School, Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital Boston, USA.
J Hand Surg Eur Vol. 2010 Jun;35(5):370-80. doi: 10.1177/1753193409357373. Epub 2009 Dec 23.
Corrective osteotomy is an established but challenging treatment for distal radius malunion. Short- and intermediate-term results have been previously published while long-term results have not. The long-term results of 22 patients treated with corrective osteotomy for symptomatic distal radius malunion are presented (range 6-24 years, mean 13 years). All patients completed the DASH questionnaire and the modified Gartland and Werley, and Green and O'Brien scores postoperatively. Wrist alignment was assessed through standard wrist radiographs. Average wrist flexion-extension was 72.5% of the contralateral limb. Grip strength averaged 71%. The DASH score averaged 16 points corresponding to mild perceived disability. Results were categorized as fair on both the Gartland and Werley score (average 9 points) and the modified Green and O'Brien score (average 67 points). Wrist alignment was maintained over time but 13 patients presented mild to moderate symptomatic wrist arthritis. The outcome presented may be a reflection of the use of stricter evaluation instruments or reflect the development of post-traumatic arthritis.
桡骨远端畸形愈合的矫正截骨术是一种既定但具有挑战性的治疗方法。此前已发表了短期和中期结果，但长期结果尚未公布。本文介绍了22例因有症状的桡骨远端畸形愈合接受矫正截骨术患者的长期结果（范围6 - 24年，平均13年）。所有患者术后均完成了DASH问卷以及改良的Gartland和Werley评分，还有Green和O'Brien评分。通过标准腕部X线片评估腕关节对线情况。患侧腕关节屈伸平均为对侧肢体的72.5%。握力平均为71%。DASH评分平均为16分，对应轻度的功能障碍感。Gartland和Werley评分（平均9分）以及改良的Green和O'Brien评分（平均67分）结果均为一般。腕关节对线随时间得以维持，但有13例患者出现了轻至中度的有症状的腕关节炎。所呈现的结果可能反映了使用了更严格的评估工具，或者反映了创伤后关节炎的发展情况。
