Herzberg G, Castel T
Service de chirurgie orthopédique main-membre supérieur, hôpital Édouard-Herriot, place d'Arsonval, 69437 Lyon cedex 03, France.
Service de chirurgie orthopédique main-membre supérieur, hôpital Édouard-Herriot, place d'Arsonval, 69437 Lyon cedex 03, France.
Hand Surg Rehabil. 2016 Dec;35S:S69-S74. doi: 10.1016/j.hansur.2016.09.005. Epub 2016 Oct 27.
Fractures of the neck and/or head of the ulna or distal ulna fracture (DUF) other than ulnar styloid fractures can occur in combination with distal radius fractures (DRF). This combination can have a significant influence on the treatment and prognosis since it causes the entire distal forearm to be unstable. In a series of 1279 consecutive unilateral DRFs, we found an associated ulnar neck fracture in 5.9% of cases, ulnar head and neck fracture in 1.6%, and isolated ulnar head fracture in 1.4%. Overall, 9% of cases in this study had a DUF with a DRF. The frequency of extra-articular "A" (11%) and intra-articular "C" (9%) DRFs according to the AO classification was about the same. There were no cases of DUF combined with partial "B" DRF. There was a correlation between combined DUF with DRF and the patient's group in the PAF classification. DUF are more frequently associated with DRF in elderly patients. Specific distal ulnar locking plates were recently introduced and they may be a useful adjunct to distal radius locking plates when treating patients with combined DUF and DRF.
尺骨颈和/或尺骨头骨折或除尺骨茎突骨折外的尺骨远端骨折（DUF）可与桡骨远端骨折（DRF）合并发生。这种合并情况会对治疗和预后产生重大影响，因为它会导致整个前臂远端不稳定。在连续的1279例单侧DRF病例中，我们发现5.9%的病例伴有尺骨颈骨折，1.6%伴有尺骨头和颈骨折，1.4%为单纯尺骨头骨折。总体而言，本研究中9%的病例为DUF合并DRF。根据AO分类，关节外“A”型（11%）和关节内“C”型（9%）DRF的发生率大致相同。没有DUF合并部分“B”型DRF的病例。在PAF分类中，DUF合并DRF与患者分组之间存在相关性。在老年患者中，DUF与DRF合并的情况更为常见。最近引入了特定的尺骨远端锁定钢板，在治疗DUF合并DRF的患者时，它们可能是桡骨远端锁定钢板的有用辅助工具。
