Department of Orthopaedics and Sports Medicine, University of Washington, Box 359798, 325 9th Avenue, Seattle, WA 98104, USA.
Department of Orthopaedics and Sports Medicine, University of Washington, Box 359798, 325 9th Avenue, Seattle, WA 98104, USA.
Hand Clin. 2024 Feb;40(1):79-87. doi: 10.1016/j.hcl.2023.08.015.
Intra-articular malunion of the distal radius represents a difficult clinical problem. While not all patients require treatment, corrective osteotomy may significantly improve motion, grip strength, and patient-reported outcome measures. Meticulous planning and technical precision are required with the possible need for multiple surgical approaches and both volar and dorsal implants. Arthroscopic assistance may be used to visualize the joint and articular reduction. Custom 3-dimensional planning guides are helpful in addressing complex multiplanar deformities. Regardless, intervention may not change the natural history of these injuries and post-traumatic arthritis is to be expected.
关节内桡骨远端畸形愈合是一个棘手的临床问题。虽然并非所有患者都需要治疗,但矫正性截骨术可显著改善关节活动度、握力和患者报告的结果测量值。需要精心规划和技术精度,并可能需要多种手术入路和掌侧及背侧植入物。关节镜辅助可用于观察关节和关节面复位。定制的三维规划导板有助于解决复杂的多平面畸形。无论如何,干预措施都可能无法改变这些损伤的自然病程,预计会发生创伤后关节炎。