Zhang Ning, Fang Jiahu
Department of Orthopedics, Yixing People's Hospital, Yixing, Jiangsu 214200, China.
Department of Orthopedics, Jiangsu Province Hospital, Nanjing, Jiangsu 210000, China.
Emerg Med Int. 2022 Sep 19;2022:5268822. doi: 10.1155/2022/5268822. eCollection 2022.
To investigate the clinical features and surgical strategies of distal radius posttraumatic deformity.
A retrospective analysis was performed on the data of 30 patients with distal radius posttraumatic deformity treated by osteotomy and orthopedic surgery in the department of orthopedics, the First Affiliated Hospital of Nanjing Medical University, from February 2016 to November 2018. All the patients underwent preoperative anterior and lateral X-ray plain scanning of bilateral wrist joints, showing different degrees of radius shortening, inferior ulnar and radial mismatch, palmar angle, and ulnar deviation angle, among which 11 patients had an uneven joint surface. After a full evaluation, osteotomy and orthopedic surgery were performed to restore the original anatomical structure, plaster fixation was performed for two weeks after surgery, and regular outpatient follow-up was conducted. The function of the wrist was evaluated by the MMWS (wrist joint improvement) scoring scale before and after surgery, and the changes in the wrist joint-related treatment parameters were evaluated according to X-ray.
All 30 patients had no neurological symptoms after surgery, and all wounds healed within the first stage. All patients were followed up for 6-12 months, with an average healing time of 3.5 months. There was no reduction loss, internal fixation loosening, or fracture in the regular postoperative review. Postoperative MMWS (wrist joint improvement) score scale data were significantly higher than those before surgery, and there were differences between groups ( < 0.05). Postoperative treatment parameters of wrist joints such as palmar inclination angle, ulnar deviation angle, radius height, and lower ulnar and radial matching were significantly improved, and there were differences between groups ( < 0.05).
The patients with distal radius posttraumatic deformity have the clinical characteristics of shortening of radius, mismatch of lower ulnar and radius, an abnormal inclination of palm, and ulnar declination. For patients with distal radius posttraumatic deformity, osteotomy and orthopedic surgery can effectively improve wrist function and improve patients' quality of life, which is worthy of clinical reference.
探讨桡骨远端创伤后畸形的临床特征及手术策略。
对2016年2月至2018年11月在南京医科大学第一附属医院骨科接受截骨矫形手术治疗的30例桡骨远端创伤后畸形患者的数据进行回顾性分析。所有患者术前行双侧腕关节正侧位X线平扫,显示不同程度的桡骨短缩、尺桡骨远端不匹配、掌倾角及尺偏角,其中11例患者关节面不平整。充分评估后,行截骨矫形手术恢复原有解剖结构,术后石膏固定2周,定期门诊随访。采用MMWS(腕关节改善)评分量表对手术前后腕关节功能进行评估,并根据X线评估腕关节相关治疗参数的变化。
30例患者术后均无神经症状,所有伤口均一期愈合。所有患者随访6~12个月,平均愈合时间为3.5个月。术后定期复查未出现复位丢失、内固定松动或骨折。术后MMWS(腕关节改善)评分量表数据显著高于术前,组间比较差异有统计学意义(<0.05)。术后腕关节掌倾角、尺偏角、桡骨高度及尺桡骨远端匹配等治疗参数均显著改善,组间比较差异有统计学意义(<0.05)。
桡骨远端创伤后畸形患者具有桡骨短缩、尺桡骨远端不匹配、掌倾角异常及尺偏的临床特点。对于桡骨远端创伤后畸形患者,截骨矫形手术可有效改善腕关节功能,提高患者生活质量,值得临床借鉴。