Yang De-fu, Zhang Gong-lin, Xia Li-ping, Hui Yu, Huang Jian-hua, Chen Jian-feng
The Tongren Orthopaedic Hospital of Dafeng City, Dafeng 224100, Jiangsu, China.
Zhongguo Gu Shang. 2010 Aug;23(8):581-4.
To analyze the cause of the postoperative shortening in distal radius fractures and to find treatment strategies to enhance the reduction effect of distal radius fracture and long-term efficacy.
From June 2005 to January 2009, 46 patients with distal radius fractures were treated by surgical operation including 17 males and 29 females,ranging from 27 to 90 years old with an average age of 48 years. All fractures were reduced satisfactory with smooth articular surface. The postoperative radial shortening was analyzed.
All patients were followed-up for 6 to 24 months with an average of 14 months. Among them, 12 patients had radial shortening. The causes of postoperative radial shortening includes: (1) patients older than 60 years; (2) severe osteoporosis; (3) preoperative displacement and comminuted fractures; (4) inappropriate fixation methods; (5) inadequate bone graft; (6) premature load.
The key points to enhance the treatment outcomes include precise judgement of the fracture type and bone quality, sufficient bone graft, firmly fixed after anatomical reduction and an appropriate plan for early loadless functional exercise. Traumatic arthritis may be avoided or delayed if the above-mentioned six causes can be taken into consideration or preventive measures can be taken.
分析桡骨远端骨折术后短缩的原因，寻找提高桡骨远端骨折复位效果及远期疗效的治疗策略。
2005年6月至2009年1月，对46例桡骨远端骨折患者行手术治疗，其中男性17例，女性29例，年龄27～90岁，平均48岁。所有骨折均获得满意复位，关节面平整，分析术后桡骨短缩情况。
所有患者均获随访，随访时间6～24个月，平均14个月。其中12例出现桡骨短缩。术后桡骨短缩的原因包括：（1）年龄大于60岁；（2）严重骨质疏松；（3）术前移位及粉碎性骨折；（4）固定方法不当；（5）植骨不足；（6）过早负重。
提高治疗效果的关键在于准确判断骨折类型及骨质情况，充分植骨，解剖复位后牢固固定，制定合适的早期不负重功能锻炼计划。若能考虑上述六个原因或采取预防措施，可避免或延缓创伤性关节炎的发生。
