Kim Jae Kwang, Kim Jong-Oh, Koh Yong-Do
1 Department of Orthopedic Surgery, Ewha Womans University School of Medicine, Seoul, Korea.
J Hand Surg Asian Pac Vol. 2016 Jun;21(2):155-60. doi: 10.1142/S2424835516400075.
The distal ulna is composed of the ulnar styloid, ulnar head, and distal ulnar metaphyseal area. Most of distal ulnar metaphyseal fractures are associated with distal radius fractures and this incidence tends to be greater in osteoporotic elderly. Consideration of the treatment of distal ulna metaphyseal fracture should be addressed after treating a distal radius fracture. If it is stable, cast immobilization is preferred, however, if it shows malalignment or instability, an operative method should be considered. More than half of distal radius fractures are combined with an ulnar styloid fracture, and considerable cases of ulnar styloid fractures result in nonunion. However, ulnar styloid nonunion usually does not cause any problems on the wrist. Recent studies of distal radius fractures treated using a volar locking plate have reported that neither the initial displacement nor the size of a concomitant ulnar styloid fracture affects clinical outcome, which suggests surgical approaches may usually not be indicated for ulnar styloid fractures.
尺骨远端由尺骨茎突、尺骨头和尺骨远端干骺端区域组成。大多数尺骨远端干骺端骨折与桡骨远端骨折相关，且这种发生率在骨质疏松的老年人中往往更高。在治疗桡骨远端骨折后，应考虑尺骨远端干骺端骨折的治疗。如果骨折稳定，首选石膏固定，然而，如果骨折出现畸形或不稳定，则应考虑手术治疗。超过一半的桡骨远端骨折合并尺骨茎突骨折，相当一部分尺骨茎突骨折会导致不愈合。然而，尺骨茎突不愈合通常不会对手腕造成任何问题。最近关于使用掌侧锁定钢板治疗桡骨远端骨折的研究报告称，初始移位和合并的尺骨茎突骨折大小均不影响临床结果，这表明对于尺骨茎突骨折通常可能无需手术治疗。
