Academic Team of Musculoskeletal Surgery, University Hospitals of Leicester NHS Trust, Leicester, UK.
Pulvertaft Hand Centre, Derby, UK.
J Hand Surg Eur Vol. 2023 Sep;48(8):798-802. doi: 10.1177/17531934231159786. Epub 2023 Mar 13.
Loss of anterior tilt after a distal radial fracture can lead to carpal malalignment, which may cause functional impairment. The aim of this study was to establish whether distal radial osteotomy for malunion, which primarily restores the dorsal tilt, will also improve carpal malalignment as measured by capitate shift. Radiographs of 67 patients who underwent osteotomy after malunion of a distal radial fracture were reviewed. Measurements of capitate shift and dorsal tilt were recorded. Linear regression modelling was used to assess the relationship between dorsal tilt and capitate shift. Change in capitate shift was strongly associated with change in dorsal tilt following osteotomy. This relationship was maintained on long-term radiographs. Capitate shift is strongly related to dorsal tilt following a distal radial fracture. Correcting the dorsal tilt during an osteotomy, therefore, will improve capitate shift and carpal malalignment. Capitate shift is unrelated to age, sex and is easy to visually assess. IV.
桡骨远端骨折畸形愈合后丢失掌倾角可导致腕骨排列不良，从而引起功能障碍。本研究旨在明确治疗桡骨远端骨折畸形愈合的桡骨远端截骨术，主要恢复背倾角，是否也能改善通过头状骨移位测量得到的腕骨排列不良。对 67 例桡骨远端骨折畸形愈合行截骨术患者的影像学资料进行了回顾性分析。记录头状骨移位和背倾角的测量值。采用线性回归模型评估背倾角与头状骨移位之间的关系。截骨术后，头状骨移位的变化与背倾角的变化有很强的相关性。这种关系在长期的影像学检查中仍然存在。桡骨远端骨折后，头状骨移位与背倾角有很强的相关性。因此，在截骨术中纠正背倾角将改善头状骨移位和腕骨排列不良。头状骨移位与年龄、性别无关，易于直观评估。IV 级。
