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桡骨远端骨折患者三角纤维软骨复合体损伤的发病机制:一项磁共振成像研究

Pathomechanism of Triangular Fibrocartilage Complex Injuries in Patients with Distal-Radius Fractures: A Magnetic-Resonance Imaging Study.

作者信息

Kim Beom-Soo, Cho Chul-Hyun, Lee Kyung-Jae, Lee Si-Wook, Byun Seok-Ho

机构信息

Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, Korea.

出版信息

J Clin Med. 2022 Oct 19;11(20):6168. doi: 10.3390/jcm11206168.

Abstract

Injury to the triangular fibrocartilage complex (TFCC) is one of the most common complications following a fracture of the distal radius. In this study, an examination of TFCC injuries in patients with distal-radius fractures was conducted using magnetic-resonance imaging (MRI); the aim of the study was to analyze the prevalence of TFCC injury as well as to suggest acceptable radiologic parameters for use in prediction of the injury pattern. Fifty-eight patients with distal-radius fractures who underwent MRI prior to undergoing open-reduction surgery between April 2020 and July 2021 were included in this study. An analysis of various radiologic parameters, the fracture type, and the MRI classification of TFCC injuries was performed. Radiologic parameters were used in the evaluation of distal radioulnar joint (DRUJ), radial shortening, and the dorsal angularity of the fracture. All of the patients in this study had definite traumatic TFCC injuries. A statistical relationship was observed between the radial length gap between the intact wrist and the injured wrist, which represents relative radial shortening, and the pattern of TFCC injury. In conclusion, the shortening of the distal radius, causing peripheral soft tissue of the ulnar side to become tauter, is highly relevant with regard to the pattern of TFCC injury. However, because no data on the clinical outcome were utilized in this study, it is lacking in clinical perspective. The conduct of further studies on patients' clinical outcome will be necessary.

摘要

三角纤维软骨复合体(TFCC)损伤是桡骨远端骨折后最常见的并发症之一。在本研究中,使用磁共振成像(MRI)对桡骨远端骨折患者的TFCC损伤进行了检查;该研究的目的是分析TFCC损伤的患病率,并提出可用于预测损伤模式的可接受的放射学参数。本研究纳入了2020年4月至2021年7月期间在接受切开复位手术前行MRI检查的58例桡骨远端骨折患者。对各种放射学参数、骨折类型和TFCC损伤的MRI分类进行了分析。放射学参数用于评估桡尺远侧关节(DRUJ)、桡骨缩短和骨折的背侧成角。本研究中的所有患者均有明确的创伤性TFCC损伤。观察到完整手腕与受伤手腕之间的桡骨长度间隙(代表相对桡骨缩短)与TFCC损伤模式之间存在统计学关系。总之,桡骨远端缩短导致尺侧周围软组织变得更紧,这与TFCC损伤模式高度相关。然而,由于本研究未使用关于临床结果的数据,缺乏临床视角。有必要对患者的临床结果进行进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/610e/9604910/21e54d66d11d/jcm-11-06168-g001.jpg

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