联合桡侧闭合楔形截骨术和尺骨短缩截骨术治疗桡骨远端骨折畸形愈合
Combined radial closing-wedge osteotomy and ulnar shortening osteotomy for distal radius malunion.
作者信息
Walch Arnaud, Pillot Sabine, Galissard Thais, Gazarian Aram, Druel Thibault
机构信息
Hôpital Edouard Herriot, 5 place d'Arsonval, 69003 Lyon, France.
Institut Chirurgical de la Main et du Membre Supérieur, 17 Avenue Condorcet, 69100 Villeurbanne, France.
出版信息
Hand Surg Rehabil. 2025 Sep;44(4):102207. doi: 10.1016/j.hansur.2025.102207. Epub 2025 Jun 13.
PURPOSE
Distal radius malunion alters wrist biomechanics, leading to pain, stiffness, and functional impairment. Various corrective osteotomy techniques exist. The aim of this study was to evaluate the functional outcomes of a combined radial closing-wedge osteotomy and ulnar shortening osteotomy in the treatment of distal radius malunions.
MATERIALS AND METHODS
We retrospectively reviewed 20 patients who underwent combined radial closing-wedge osteotomy and ulnar shortening osteotomy for symptomatic distal radius malunions. Functional outcomes, grip strength, range of motion, and radiographic parameters were analyzed.
RESULTS
Surgery significantly improved supination (20°-80°), flexion (40°-60°), extension (50°-65°), and grip strength (12 kg-22 kg). Ulnar variance correction was achieved. Complications occurred in four cases, with three requiring revision surgery.
DISCUSSION
Combined radial closing-wedge osteotomy and ulnar shortening osteotomy effectively restores wrist function while avoiding graft-related complications. This approach provides an alternative to opening-wedge osteotomies for distal radius malunions.
LEVEL OF EVIDENCE
IV.
目的
桡骨远端畸形愈合会改变腕关节生物力学，导致疼痛、僵硬和功能障碍。存在多种矫正截骨技术。本研究的目的是评估桡骨闭合楔形截骨联合尺骨短缩截骨术治疗桡骨远端畸形愈合的功能结果。
材料与方法
我们回顾性分析了20例因有症状的桡骨远端畸形愈合而接受桡骨闭合楔形截骨联合尺骨短缩截骨术的患者。分析了功能结果、握力、活动范围和影像学参数。
结果
手术显著改善了旋后（从20°至80°）、屈曲（从40°至60°）、伸展（从50°至65°）以及握力（从12千克至22千克）。实现了尺骨变异的矫正。4例出现并发症，其中3例需要翻修手术。
讨论
桡骨闭合楔形截骨联合尺骨短缩截骨术可有效恢复腕关节功能，同时避免与植骨相关的并发症。这种方法为桡骨远端畸形愈合的开放楔形截骨术提供了一种替代方案。
证据级别
IV级。
Zotero 插件