Lirola-Palmero S, Salvà-Coll G, Terrades-Cladera F J
Departamento de Cirugía Ortopédica y Traumatología, Hospital Son Llàtzer, Palma de Mallorca, España.
Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Son Espases, Palma de Mallorca, España.
Rev Esp Cir Ortop Traumatol. 2015 May-Jun;59(3):150-6. doi: 10.1016/j.recot.2014.08.002. Epub 2014 Dec 3.
Ulnar variance may be a risk factor of developing scaphoid non-union.
A review was made of the posteroanterior wrist radiographs of 95 patients who were diagnosed of scaphoid fracture. All fractures with displacement less than 1mm treated conservatively were included. The ulnar variance was measured in all patients.
Ulnar variance was measured in standard posteroanterior wrist radiographs of 95 patients. Eighteen patients (19%) developed scaphoid nonunion, with a mean value of ulnar variance of -1.34 (-/+ 0.85) mm (CI -2.25 - 0.41). Seventy seven patients (81%) healed correctly, and the mean value of ulnar variance was -0.04 (-/+ 1.85) mm (CI -0.46 - 0.38). A significant difference was observed in the distribution of ulnar variance (p<.05). These results remained significant after adjusting for age, with an OR of 0.69 (CI 0.49 to 0.95). The patients were categorized into two groups: ulnar variance less than -1mm, and ulnar variance greater than -1mm. It appears that patients with ulnar variance less than -1mm had an OR 4.58 (CI 1.51 to 13.89) with p<.007.
Desai et al. concluded that radiological features of acute scaphoid fractures cannot be used to predict the likelihood of fracture union. For this reason, the existence of other risk factors was analysed. According to the results of the present study, it can be concluded that patients with scaphoid fracture and ulnar variance less than -1mm have a greater risk of developing scaphoid nonunion, OR 4.58 (CI 1.51 to 13.89) with p<.007.
尺骨变异可能是舟骨不愈合的一个风险因素。
回顾性分析95例被诊断为舟骨骨折患者的腕关节正位X线片。纳入所有保守治疗且移位小于1mm的骨折病例。对所有患者测量尺骨变异。
在95例患者的标准腕关节正位X线片上测量了尺骨变异。18例患者（19%）发生舟骨不愈合，尺骨变异平均值为-1.34（±0.85）mm（可信区间-2.25至-0.41）。77例患者（81%）骨折顺利愈合，尺骨变异平均值为-0.04（±1.85）mm（可信区间-0.46至0.38）。尺骨变异分布存在显著差异（p<0.05）。在调整年龄后，这些结果仍然显著，优势比为0.69（可信区间0.49至0.95）。将患者分为两组：尺骨变异小于-1mm组和尺骨变异大于-1mm组。似乎尺骨变异小于-1mm的患者优势比为4.58（可信区间1.51至13.89），p<0.007。
德赛等人得出结论，急性舟骨骨折的放射学特征不能用于预测骨折愈合的可能性。因此，对其他风险因素的存在进行了分析。根据本研究结果，可以得出结论，舟骨骨折且尺骨变异小于-1mm的患者发生舟骨不愈合的风险更大，优势比为4.58（可信区间1.51至13.89），p<0.007。
