Shirakawa Ken, Shirota Masahiko
Department of Orthopaedic Surgery, Saitama Red Cross Hospital, Saitama-ken, Japan.
Tech Hand Up Extrem Surg. 2013 Sep;17(3):158-61. doi: 10.1097/BTH.0b013e3182995824.
Distal radius fractures often accompany ulnar styloid fractures. As basal ulnar styloid fractures sometimes result in symptomatic nonunion causing distal radioulnar joint instability, surgical intervention should be considered as a method of treatment. However, conventional methods of internal fixation for ulnar styloid involving tension band wiring and pinning often causes irritation of hardware, and required further surgery. We performed T.A.C.' pin fixation for basal ulnar styloid fractures associated with distal radius fractures in 24 patients. X-rays showed union at an average of 6.8 weeks postoperatively in all but 1 case, which resulted in asymptomatic fibrous nonunion. Irritation from the hardware was recognized in 3 cases, but soon disappeared after recutting or removal of the pin. At the final follow-up, no symptoms involving ulnar wrist pain or distal radioulnar instability were noted. T.A.C.' pin fixation for basal ulnar styloid is a useful method and rarely requires further surgery compared with conventional methods.
桡骨远端骨折常伴有尺骨茎突骨折。由于尺骨茎突基底部骨折有时会导致有症状的骨不连，引起下尺桡关节不稳定，因此应考虑将手术干预作为一种治疗方法。然而，传统的尺骨茎突内固定方法，如张力带钢丝固定和克氏针固定，常常会引起内固定物刺激，需要进一步手术。我们对24例与桡骨远端骨折相关的尺骨茎突基底部骨折患者采用了T.A.C. 针固定。X线显示，除1例导致无症状性纤维性骨不连外，其余所有病例平均在术后6.8周达到骨愈合。有3例出现了内固定物刺激，但在重新截断或取出克氏针后很快消失。在最后一次随访时，未发现涉及尺侧腕部疼痛或下尺桡关节不稳定的症状。与传统方法相比，T.A.C. 针固定尺骨茎突基底部是一种有效的方法，很少需要进一步手术。
