Department of Orthopedic Surgery, Ewha Womans University Mokdong Hospital, 911-1, Mok-6-dong, Yangcheon-gu, Seoul, 158-710, South Korea.
J Bone Joint Surg Am. 2010 Jan;92(1):1-6. doi: 10.2106/JBJS.H.01738.
Ulnar styloid fractures often occur in association with distal radial fractures. The purpose of this study was to determine whether an associated ulnar styloid fracture following stable fixation of a distal radial fracture has any effect on wrist function or on the development of chronic distal radioulnar joint instability.
One hundred and thirty-eight consecutive patients who underwent surgical treatment of an unstable distal radial fracture were included in this study. During surgery, none of the accompanying ulnar styloid fractures were internally fixed. Patients were divided into nonfracture, nonbase fracture, and base fracture groups, on the basis of the location of the ulnar styloid fracture, and into nonfracture, minimally displaced (< or =2 mm), and considerably displaced (>2 mm) groups, according to the amount of ulnar styloid fracture displacement at the time of injury. Postoperative evaluation included measurement of grip strength and wrist range of motion; calculation of the modified Mayo wrist score and Disabilities of the Arm, Shoulder and Hand score; as well as testing for instability of the distal radioulnar joint at a mean of nineteen months postoperatively.
Ulnar styloid fractures were present in seventy-six (55%) of the 138 patients. Forty-seven (62%) involved the nonbase portion of the ulnar styloid and twenty-nine (38%) involved the base of the ulnar styloid. Thirty-four (45%) were minimally displaced, and forty-two (55%) were considerably (>2 mm) displaced. We did not find a significant relationship between wrist functional outcomes and ulnar styloid fracture level or the amount of displacement. Chronic instability of the distal radioulnar joint occurred in two wrists (1.4%).
An accompanying ulnar styloid fracture in patients with stable fixation of a distal radial fracture has no apparent adverse effect on wrist function or stability of the distal radioulnar joint.
尺骨茎突骨折常与桡骨远端骨折同时发生。本研究旨在确定桡骨远端骨折稳定固定后发生的伴随尺骨茎突骨折是否会对腕关节功能或慢性下尺桡关节不稳定的发展产生任何影响。
本研究纳入了 138 例接受不稳定型桡骨远端骨折手术治疗的连续患者。在手术过程中，未对内固定任何伴随的尺骨茎突骨折。根据尺骨茎突骨折的位置，患者分为无骨折、非基底部骨折和基底部骨折组，根据受伤时尺骨茎突骨折的移位量，分为无骨折、轻度移位（≤2mm）和明显移位（>2mm）组。术后评估包括握力和腕关节活动范围的测量；改良 Mayo 腕关节评分和上肢残疾评分的计算；以及平均术后 19 个月时下尺桡关节不稳定的检测。
在 138 例患者中，76 例（55%）存在尺骨茎突骨折。47 例（62%）累及尺骨茎突非基底部，29 例（38%）累及尺骨茎突基底部。34 例（45%）为轻度移位，42 例（55%）为明显移位（>2mm）。我们没有发现腕关节功能结果与尺骨茎突骨折水平或移位量之间存在显著关系。慢性下尺桡关节不稳定仅发生在 2 例腕关节（1.4%）。
桡骨远端骨折稳定固定后发生的伴随尺骨茎突骨折对腕关节功能或下尺桡关节的稳定性没有明显的不良影响。
