Zhao Liang, Wang Bao-jun, Li Ya-dong, Yu Hao-sen, Liu Zhen-yu, Gao Hua, Liu Chang-gui
Department of Orthopedics, Beijing Friendship Hospital-Affiliate of Capital University of Medical Sciences, Beijing 100050, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2011 Oct 18;43(5):675-80.
To analyze the result of the distal radial fractures with or without ulnar styloid fracture.
From January 2007 to October 2010, 62 cases with distal radial fractures were treated by ORIF, of which 52 were followed-up entirely with an average of 15 months (6-34 months), including 6 male cases and 46 female cases at an average age of (62.25±8.25) years. All ulnar styloid fractures were not fixed. According to ulnar styloid fractures, all cases were divided into two groups, group A (32 cases with ulnar styloid fractures) and group B (20 cases without). Group A was further divided into type I (tip fracture of ulnar styloid, 12 cases) and type II (base fracture of ulnar styloid, 20 cases). AO classification, volar tilt, radial inclination and radial height were recorded before and after operation. Complications and Garlant-Werley Scores were evaluated 3 months and 1 year after operation.
All distal radial fractures were union in 8 weeks to 12 weeks. There were significant differences in radial inclination and radial process height, but not in volar tilt between groups A and B before operation. We found no significant differences in volar tilt, radial inclination, radial process height and Garlant-Werley scores between groups A and B 3 months and 1 year after operation. There were also no significant differences between type I and type II. Fineness was 81%. Complications were found in 6 cases (4 in group A and 2 in group B), in which there were 1 case with a screw cutting-off and traumatic arthritis, 2 cases with sup-nerve injury and 1 case with heterotopic ossification, 1 case of malunion , and 1 case with wrist stiffness and traumatic arthritis.
ORIF with locking plate in distal radial fracture is safe and effective. There is no significant difference between the outcomes of patients with and without ulnar styloid fractures, also in patients with type I and type II fractures, union or nonunion of fractures, according to the X-ray measurement and Garlant-Werley wrist function scores. However, long-term following-up is still needed.
分析伴有或不伴有尺骨茎突骨折的桡骨远端骨折的治疗结果。
2007年1月至2010年10月，62例桡骨远端骨折患者接受切开复位内固定术治疗，其中52例获得完整随访，平均随访15个月（6 - 34个月），包括男性6例，女性46例，平均年龄（62.25±8.25）岁。所有尺骨茎突骨折均未进行固定。根据尺骨茎突骨折情况，将所有病例分为两组，A组（32例伴有尺骨茎突骨折）和B组（20例不伴有尺骨茎突骨折）。A组进一步分为Ⅰ型（尺骨茎突尖部骨折，12例）和Ⅱ型（尺骨茎突基部骨折，20例）。记录手术前后的AO分型、掌倾角、桡偏角和桡骨高度。术后3个月和1年评估并发症及Garlant-Werley评分。
所有桡骨远端骨折均在8周至12周内愈合。术前A组和B组在桡偏角和桡骨高度方面存在显著差异，但掌倾角无显著差异。术后3个月和1年，A组和B组在掌倾角、桡偏角、桡骨高度和Garlant-Werley评分方面均无显著差异。Ⅰ型和Ⅱ型之间也无显著差异。优良率为81%。6例出现并发症（A组4例，B组2例），其中1例螺钉切割及创伤性关节炎，2例尺神经损伤，1例异位骨化，1例畸形愈合，1例腕关节僵硬及创伤性关节炎。
桡骨远端骨折采用锁定钢板切开复位内固定术安全有效。根据X线测量及Garlant-Werley腕关节功能评分，伴有或不伴有尺骨茎突骨折的患者、Ⅰ型和Ⅱ型骨折患者、骨折愈合或不愈合患者的治疗结果无显著差异。然而，仍需要长期随访。
