Park Min Jong, Lee Yong Beom, Kim Hyo Gon
Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Acta Orthop Belg. 2012 Apr;78(2):175-82.
We evaluated fourteen patients who had restricted supination as a major impairment related with a malunited radius fracture. All patients underwent an opening wedge corrective osteotomy, bone grafting, and volar plate fixation. Clinical results were assessed based on range of motion, visual analogue scale for pain, grip power, and a Modified Mayo Wrist Score. The mean supination increased from 24 degrees preoperatively to 71 degrees postoperatively (p < 0.01). Dorsiflexion range, grip power and pain score improved significantly after the operation. The mean value for the Modified Mayo Wrist score improved from 58.6 points to 83.9 points (p < 0.01). Radiological measurements showed that the degree of dorsal angulation decreased from a mean of 9.0 degrees to -2.5 degrees after the corrective osteotomy. This study demonstrated that a malunited radius fracture with dorsal angulation, even if the latter appears mild, can induce functional impairment due to limited range of supination. Supination can be restored by an appropriately performed corrective osteotomy.
我们评估了14例以旋后受限作为主要功能障碍且与桡骨骨折畸形愈合相关的患者。所有患者均接受了开放性楔形截骨、植骨及掌侧钢板固定术。基于活动范围、疼痛视觉模拟评分、握力及改良梅奥腕关节评分对临床结果进行评估。平均旋后角度从术前的24°增加至术后的71°（p<0.01）。背伸范围、握力及疼痛评分在术后显著改善。改良梅奥腕关节评分的平均值从58.6分提高至83.9分（p<0.01）。影像学测量显示，截骨矫形术后背侧成角度数从平均9.0°降至-2.5°。本研究表明，伴有背侧成角的桡骨骨折畸形愈合，即使背侧成角看似较轻，也可因旋后范围受限而导致功能障碍。通过适当实施的截骨矫形术可恢复旋后功能。
