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桡骨远端骨折切开复位中远端骨折块残余桡侧移位的矫正

Correction of Residual Radial Translation of the Distal Fragment in Distal Radius Fracture Open Reduction.

作者信息

Ross Mark, Allen Lex, Couzens Gregory B

机构信息

Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Queensland, Australia; Orthopaedic Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; School of Medicine, The University of Queensland, St. Lucia, Queensland, Australia.

Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Queensland, Australia; Orthopaedic Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; Southern Utah Orthopedics and Sports Medicine Clinic, Valley View Medical Centre, Cedar City, Utah.

出版信息

J Hand Surg Am. 2015 Dec;40(12):2465-70. doi: 10.1016/j.jhsa.2015.09.008. Epub 2015 Oct 17.

Abstract

Distal radius fractures are common injuries of the upper extremity requiring treatment. In recent years, volar locking plate (VLP) fixation has become favored for operative treatment with the main goals being anatomic reduction and rigid fixation allowing for an early range of motion rehabilitation protocol. VLP fixation is excellent at correcting sagittal plane alignment with restoration of volar tilt. However, plate designs do not have any intrinsic features to their designs to assist with correction of coronal plane translation. One possible sequela of distal radius fractures is residual instability of the distal radioulnar joint. This instability can lead to pain and disability after treatment of distal radius fractures requiring further interventions. It has been demonstrated that coronal plane malreduction with residual radial translation of the distal fragment may contribute to ongoing distal radioulnar joint instability after distal radius fractures. We describe a technique for intraoperative correction of residual radial translation. It may be used when radial translation is recognized during internal fixation with a VLP or when correction of radial translation is required as part of a corrective osteotomy for radial malunion.

摘要

桡骨远端骨折是上肢常见的需要治疗的损伤。近年来,掌侧锁定钢板(VLP)固定已成为手术治疗的首选方法,主要目标是解剖复位和坚强固定,以便能够实施早期活动康复方案。VLP固定在纠正矢状面排列和恢复掌倾角方面效果极佳。然而,钢板设计本身没有任何有助于纠正冠状面移位的特征。桡骨远端骨折的一个可能后遗症是下尺桡关节残留不稳定。这种不稳定可导致桡骨远端骨折治疗后出现疼痛和功能障碍,需要进一步干预。已经证明,冠状面复位不良且远端骨折块残留桡侧移位可能导致桡骨远端骨折后持续存在下尺桡关节不稳定。我们描述了一种术中纠正残留桡侧移位的技术。当在使用VLP内固定过程中发现桡侧移位时,或作为桡骨畸形愈合矫正截骨术的一部分需要纠正桡侧移位时,均可使用该技术。

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