Arimitsu Sayuri, Moritomo Hisao
Department of Orthopaedic Surgery, Yukioka Hospital, Kita-ku, Osaka-shi Osaka, Japan.
Osaka Yukioka College of Health Science, Yukioka Hospital Hand Center, Kita-ku, Osaka-shi Osaka, Japan.
J Hand Surg Am. 2016 Feb;41(2):233-6. doi: 10.1016/j.jhsa.2015.11.005. Epub 2015 Dec 24.
We report a patient with bidirectional dislocation of the distal radioulnar joint after malunited distal radius fracture, in which the ulnar head dislocated dorsally during forearm pronation and palmarly during supination without manual compression of the ulnar head. The patient had chronic ulnar wrist pain and experienced a painful clunk during forearm rotation. The distal radioulnar joint ballottement test was positive in both the dorsal and palmar directions. Her distal radius was malunited with a 20° dorsal angulation and 18° pronation deformity. A corrective osteotomy of the radius with open repair of the triangular fibrocartilage complex foveal avulsion yielded success. At the 7-year follow-up, there was almost a normal range of wrist and forearm motion, 83% grip strength, no arthritis, and a stable distal radioulnar joint.
我们报告1例桡骨远端骨折畸形愈合后发生远侧桡尺关节双向脱位的患者，该患者在无手法按压尺骨头的情况下，前臂旋前时尺骨头背侧脱位，旋后时掌侧脱位。患者有慢性尺侧腕部疼痛，前臂旋转时出现疼痛性弹响。远侧桡尺关节冲击试验在背侧和掌侧方向均为阳性。其桡骨远端畸形愈合，有20°的背侧成角和18°的旋前畸形。采用桡骨截骨矫正并开放修复三角纤维软骨复合体中央凹撕脱取得成功。在7年的随访中，腕关节和前臂活动范围基本正常，握力为正常的83%，无关节炎，远侧桡尺关节稳定。
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