Li Shuzhen, Wang Hao, Su Bo, Han Jie, Liang Haibo, Sun Ke, Yin Dong
1Department of Orthopedic Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530021 China.
2Departmen of Orthopedic Surgery, The Affiliated Ruikang Hospital of Guangxi University of Chinese Medicine, Nanning, 530011 China.
Indian J Orthop. 2020 Jan 24;54(1):75-82. doi: 10.1007/s43465-019-00016-2. eCollection 2020 Feb.
There is a controversy regarding whether ulnar styloid fractures affect the efficacy of treatment of distal radial fractures. The purpose of this study was to investigate whether ulnar styloid fractures impact wrist joint function in patients without distal radioulnar joint instability, after distal radial fracture fixation using a volar plate.
Seventy-five patients with a distal radial fracture were treated using a volar plate between February 2010 and February 2016 (33 men and 42 women; mean age 40.9 ± 9.4 years). Forty-four patients had ulnar styloid fractures (Group A) and 31 patients did not (Group B). There were no differences between the two groups with regard to sex, age, course of the disease and fracture type (> 0.05).
The mean follow-up time was 21 months. There were no differences between the groups in palmar tilt, radial inclination and radial length when the distal radial fractures had healed (> 0.05). At the final follow-up visit, the two groups were similar in terms of wrist motion range, and grip and pinch strength (> 0.05). The Gartland-Werley scores were 13 for excellent, 26 for good, 3 for fair and 2 for poor (excellence rate 89%) for Group A, and 10 for excellent, 17 for good, 2 for fair and 2 for poor (excellence rate 87%) for Group B. The difference between the two groups was not significant (Z = - 0.097, = 0.922).
After open reduction and plate fixation of distal radial fractures, if stability of the distal radioulnar joint is achieved, untreated ulnar styloid fractures have no impact on wrist joint function.
尺骨茎突骨折是否影响桡骨远端骨折的治疗效果存在争议。本研究的目的是探讨在使用掌侧钢板固定桡骨远端骨折后，尺骨茎突骨折对无下尺桡关节不稳定患者的腕关节功能是否有影响。
2010年2月至2016年2月期间，75例桡骨远端骨折患者接受了掌侧钢板治疗（33例男性，42例女性；平均年龄40.9±9.4岁）。44例患者伴有尺骨茎突骨折（A组），31例患者无尺骨茎突骨折（B组）。两组在性别、年龄、病程和骨折类型方面无差异（>0.05）。
平均随访时间为21个月。桡骨远端骨折愈合时，两组在掌倾角、桡偏角和桡骨长度方面无差异（>0.05）。在末次随访时，两组在腕关节活动范围、握力和捏力方面相似（>0.05）。A组Gartland-Werley评分：优13例，良26例，可3例，差2例（优良率89%）；B组：优10例，良17例，可2例，差2例（优良率87%）。两组间差异无统计学意义（Z=-0.097，P=0.922）。
桡骨远端骨折切开复位钢板固定后，如下尺桡关节稳定，未处理的尺骨茎突骨折对腕关节功能无影响。
