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处理关节外桡骨远端畸形愈合。

Managing the Extra-Articular Distal Radius Malunion.

机构信息

Department of Orthopedics, University of Colorado School of Medicine, 13001 East 17th Place, Aurora, CO 80045, USA.

Department of Orthopedics, University of Colorado School of Medicine, 13001 East 17th Place, Aurora, CO 80045, USA; Department of Orthopedics, Denver Health Medical Center, Denver, CO, USA.

出版信息

Hand Clin. 2024 Feb;40(1):63-77. doi: 10.1016/j.hcl.2023.06.002. Epub 2023 Jul 11.

Abstract

Distal radius fractures are common injuries. Satisfactory outcomes are typically achieved with appropriate nonoperative or operative treatment. A proportion of these injuries develop symptomatic malunions, which may be treated surgically with distal radius corrective osteotomy. A thorough understanding of the anatomy, biomechanics, radiographic parameters, and indications is needed to provide appropriate treatment. Factors, including surgical approach, osteotomy type, use of bone graft, fixation construct, management of associated tendon and/or nerve conditions, soft tissue contracture releases, and need for ulnar-sided procedures, should be considered. A comprehensive evaluation is necessary to guide understanding for when salvage procedures may be preferred.

摘要

桡骨远端骨折很常见。适当的非手术或手术治疗通常可获得满意的结果。这些损伤中有一部分会出现有症状的愈合不良,可能需要通过桡骨远端矫正截骨术进行手术治疗。为了提供适当的治疗,需要充分了解解剖结构、生物力学、影像学参数和适应证。应考虑包括手术入路、截骨类型、植骨的使用、固定结构、相关肌腱和/或神经状况的处理、软组织挛缩松解以及尺侧手术的需要等因素。需要进行全面评估,以指导理解何时可能需要采用挽救性手术。

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