Li Shuzhen, Chen Yueping, Lin Zonghan, Fan Qie, Cui Wei, Feng Zhe
Department of Orthopedics, the Affiliated Ruikang Hospital, Guangxi Traditional Chinese Medical College, Nanning Guangxi, 530011, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012 Jun;26(6):666-70.
To evaluate the effect of associated ulnar styloid fracture on wrist function after distal radius fracture by comparing the clinical data between the cases of distal radius fracture with or without ulnar styloid fractures.
The clinical data of 182 patients with distal radius fracture between February 2005 and May 2010 were retrospectively analyzed, including 75 with ulnar styloid fracture (group A), and 107 without ulnar styloid fracture (group B). There was no significant difference in sex, age, disease duration, and fracture classification between 2 groups (P > 0.05). In groups A and B, closed reduction and splintlet or cast fixation were performed in 42 and 63 cases respectively, and open reduction and internal fixation in 33 and 44 cases respectively. All ulnar styloid fractures were not treated.
The patients were followed up 21 months on average in group A and 20 months on average in group B. All incisions healed by first intention after operation. Ulnar wrist pain occurred in 4 patients (5.3%) of group A and 6 patients (5.6%) of group B, showing no significant difference (chi2=0.063, P=0.802). The fracture healing time was (10.9 +/- 2.7) weeks in group A and (11.6 +/- 2.3) weeks in group B, showing no significant difference (t=1.880, P=0.062). There was no significant difference in the palmar tilt angle, the ulnar inclination angle, and the radial length between groups A and B when fracture healing (P > 0.05). At last follow-up, there was no significant difference in wrist flexion-extension, radial-ulnar deviation, pronation-supination, and grip and pinch strength between 2 groups (P > 0.05). According to the Gartland-Werley score in groups A and B, the results were excellent in 24 and 35 cases, good in 43 and 57 cases, fair in 5 and 10 cases, and poor in 3 and 5 cases with execllent and good rate of 89.3% and 86.0%, respectively, showing no significant difference between 2 groups (Z=0.203, P=0.839). There were significant differences in the above indexes between patients undergoing closed reduction and open reduction in group A (P < 0.05).
Associated ulnar styloid fracture has no obvious effect on the wrist function after distal radius fracture. The anatomical reduction of distal radial fracture is the crucial importance in the treatment of distal radial fracture accompanying ulnar styloid fracture.
通过比较桡骨远端骨折伴或不伴尺骨茎突骨折患者的临床资料，评估尺骨茎突骨折对桡骨远端骨折后腕关节功能的影响。
回顾性分析2005年2月至2010年5月间182例桡骨远端骨折患者的临床资料，其中75例伴有尺骨茎突骨折（A组），107例不伴有尺骨茎突骨折（B组）。两组患者在性别、年龄、病程及骨折分型方面差异无统计学意义（P>0.05）。A组和B组分别有42例和63例行闭合复位夹板或石膏固定，33例和44例行切开复位内固定。所有尺骨茎突骨折均未作处理。
A组患者平均随访21个月，B组平均随访20个月。术后所有切口均一期愈合。A组4例（5.3%）、B组6例（5.6%）出现尺侧腕部疼痛，差异无统计学意义（χ2=0.063，P=0.802）。A组骨折愈合时间为（10.9±2.7）周，B组为（11.6±2.3）周，差异无统计学意义（t=1.880，P=0.062）。骨折愈合时A组与B组在掌倾角、尺偏角及桡骨长度方面差异无统计学意义（P>0.05）。末次随访时，两组在腕关节屈伸、桡尺偏、旋前旋后及握力和捏力方面差异无统计学意义（P>0.05）。根据Gartland-Werley评分，A组优24例、良43例、可5例、差3例，优良率为89.3%；B组优35例、良57例、可10例、差5例，优良率为86.0%，两组差异无统计学意义（Z=0.203，P=0.839）。A组中闭合复位与切开复位患者上述指标比较差异有统计学意义（P<0.05）。
尺骨茎突骨折对桡骨远端骨折后腕关节功能无明显影响。桡骨远端骨折的解剖复位在治疗桡骨远端骨折伴尺骨茎突骨折中至关重要。
