Watson H K, Castle T H
Connecticut Combined Hand Service, Hartford.
J Hand Surg Am. 1988 Nov;13(6):837-43. doi: 10.1016/0363-5023(88)90257-2.
Loss of radial palmar tilt in malunion of Colles' fractures alters wrist biomechanics, abnormally loading the tenuous dorsal ligament complex. This can result in midcarpal instability with synovitis, pain, weakness, and possible articular degeneration. An osteotomy to correct radius alignment using a trapezoidal corticocancellous bone graft has been devised. The graft is harvested from the dorsal radius adjacent to the osteotomy and malunion site. When turned 90 degrees, a properly designed trapezoidal graft restores radial length, inclination, and palmar tilt in one step. Functional results in 15 patients at 46 months (range, 18 to 116) were comparable with a series using iliac crest graft and plate- and-screw fixation. This simple technique avoids disruption of the extensor retinaculum and reoperation for hardware removal as Kirschner-wire fixation proved adequate.
科雷氏骨折畸形愈合时桡侧掌倾角的丧失会改变腕关节生物力学，异常加载脆弱的背侧韧带复合体。这可能导致腕中关节不稳定，并伴有滑膜炎、疼痛、无力以及可能的关节退变。已设计出一种使用梯形皮质松质骨移植来纠正桡骨对线的截骨术。移植骨取自靠近截骨术和畸形愈合部位的桡骨背侧。当旋转90度时，设计合理的梯形移植骨可一步恢复桡骨长度、倾斜度和掌倾角。15例患者在46个月（范围为18至116个月）时的功能结果与使用髂嵴移植骨及钢板螺钉固定的一组病例相当。这种简单技术避免了伸肌支持带的破坏以及因克氏针固定已被证明足够而进行的取出内固定物的再次手术。
