Bauer G, Arand M, Mutschler W
Abteilung für Unfall-, Hand-, Plastische- und Wiederherstellungschirurgie, Universität Ulm, Federal Republic of Germany.
Arch Orthop Trauma Surg. 1991;110(3):142-5. doi: 10.1007/BF00395796.
One hundred sixty-seven forearm fractures treated with plate osteosynthesis were analyzed for synostosis occurring between the radius and the ulna. Eleven cases (6.6%) were found, in 7 of which both bones of the forearm had been fractured, while the other 4 were cases of isolated radial or ulnar fracture. Overall there were 89 cases of fracture of both bones; of the 65 cases treated utilizing the two-incision approach, cross-union was seen in only 1, while in a comparable group (12 cases) in which the fractures were stabilized using the Boyd approach, there were 5 synostoses. In 38 cases of isolated ulna fracture, only 2 synostoses were seen one associated with severe soft-tissue trauma and the other arising after treatment with a modified Boyd approach. Among 40 isolated radial fractures, 2 radioulnar synostoses occurred, one in an open fracture and the other after fixation via the Boyd approach. These results emphasize the importance of using two approaches for fractures of both forearm bones. The highest risk of post-osteosynthetic synostosis appears to be in fractures of the proximal third of both radius and ulna.
对167例采用钢板内固定治疗的前臂骨折患者进行分析，以观察桡骨与尺骨之间是否发生骨融合。发现11例（6.6%）发生骨融合，其中7例前臂双骨均骨折，另外4例为单纯桡骨或尺骨骨折。总体而言，有89例双骨骨折；在采用双切口入路治疗的65例患者中，仅1例出现交叉融合，而在采用博伊德（Boyd）入路固定骨折的可比组（12例）中，有5例发生骨融合。在38例单纯尺骨骨折中，仅2例发生骨融合，1例与严重软组织创伤有关，另1例在采用改良博伊德入路治疗后出现。在40例单纯桡骨骨折中，发生2例桡尺骨融合，1例在开放性骨折中出现，另1例在采用博伊德入路固定后出现。这些结果强调了对前臂双骨骨折采用两种入路的重要性。钢板内固定术后发生骨融合的最高风险似乎在于桡骨和尺骨近端三分之一处的骨折。
