Lee Ho-Won, Kim Ki-Tae, Lee Sanghyeon, Yoon Joon-Hyeok, Kim Jung-Youn
Department of Orthopedic Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul 07441, Republic of Korea.
Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Republic of Korea.
J Clin Med. 2024 Feb 8;13(4):992. doi: 10.3390/jcm13040992.
The purpose of this study was to investigate the fracture morphology of distal radius fractures (DRFs) with the status of triangular fibrocartilage complex (TFCC) foveal insertion in patients with or without osteoporosis and to identify the relationship between osteoporosis and foveal tear. Seventy-five patients who underwent surgery for DRF from January 2021 to September 2023 were included. All patients were evaluated by standard radiography and dual-energy X-ray absorptiometry and underwent a 3.0 T magnetic-resonance imaging examination of the involved wrist to identify TFCC foveal tear. Patients were allocated into two groups according to the presence of osteoporosis: patients with osteoporosis (group I) and those without osteoporosis (group II). Group I showed a significantly larger displacement of fractures compared to group II (radial inclination; 13.7 ± 5.4 vs. 17.9 ± 4.2; < 0.001, dorsal angulation; 22.2 ± 12.1 vs. 16.5 ± 9.4; = 0.024, ulnar variance; 4.15 ± 2.1 vs. 2.2 ± 1.9; < 0.001). Dorsal angulation and ulnar variance were found to be independent prognostic factors for TFCC foveal tear in logistic regression analysis. Displacement of fractures was related to osteoporosis, and dorsal angulation and ulnar variance were independent prognostic factors for TFCC foveal tear. However, osteoporosis was not identified as a factor associated with TFCC foveal tears.
本研究的目的是调查伴有或不伴有骨质疏松症的桡骨远端骨折（DRF）患者的骨折形态以及三角纤维软骨复合体（TFCC）中央凹附着情况，并确定骨质疏松症与中央凹撕裂之间的关系。纳入了2021年1月至2023年9月期间接受DRF手术的75例患者。所有患者均接受标准X线摄影和双能X线吸收法评估，并对受累腕关节进行3.0T磁共振成像检查以确定TFCC中央凹撕裂情况。根据是否存在骨质疏松症将患者分为两组：骨质疏松症患者（I组）和无骨质疏松症患者（II组）。I组骨折移位明显大于II组（桡侧倾斜度：13.7±5.4对17.9±4.2；<0.001，背侧成角：22.2±12.1对16.5±9.4；=0.024，尺骨变异：4.15±2.1对2.2±1.9；<0.001）。逻辑回归分析发现背侧成角和尺骨变异是TFCC中央凹撕裂的独立预后因素。骨折移位与骨质疏松症有关，背侧成角和尺骨变异是TFCC中央凹撕裂的独立预后因素。然而，骨质疏松症未被确定为与TFCC中央凹撕裂相关的因素。
