Wainapel S F, Davis L, Rogoff J B
Am J Phys Med. 1981 Jun;60(3):126-31.
Thirty-three patients with unilateral Colles fracture were evaluated by clinical and electrodiagnostic methods to determine the frequency of concomitant ipsilateral carpal tunnel syndrome. Four cases were documented, an incidence of 12.1%; this is two to four times greater than the incidence previously reported in the orthopaedic literature. Four other cases showed bilateral carpal tunnel syndrome, on of which was more more severe on the fracture side. Although electrodiagnosis was not found to be a more sensitive diagnostic indicator than was careful history and physical examination is these patients, it was useful in objectively confirming the clinical impression and assessing the severity of involvement. Recovery of hand function was not adversely affected by the presence of carpal tunnel syndrome in our cases. In view of the rather frequent occurrence of this complication, it is recommended that all patients with Colles fracture be carefully evaluated for the presence of symptoms or signs suggesting median nerve compression, and that all suspected cases by referred for early electrodiagnostic evaluation.
对33例单侧科雷氏骨折患者采用临床和电诊断方法进行评估,以确定同侧腕管综合征的并发频率。记录到4例,发病率为12.1%;这比骨科文献中先前报道的发病率高两到四倍。另外4例显示双侧腕管综合征,其中1例在骨折侧更为严重。虽然在这些患者中,电诊断并未被发现是比仔细的病史和体格检查更敏感的诊断指标,但它有助于客观地证实临床印象并评估受累的严重程度。在我们的病例中,腕管综合征的存在并未对手功能的恢复产生不利影响。鉴于这种并发症相当常见,建议对所有科雷氏骨折患者仔细评估是否存在提示正中神经受压的症状或体征,并将所有疑似病例转诊进行早期电诊断评估。