Hutchinson F
Miller Orthopaedic Clinic, Charlotte, NC 28203, USA.
J South Orthop Assoc. 1995 Spring;4(1):53-68.
Approaches to malunion of the distal radius may be viewed as a hierarchy of surgical options with increasing complexity and potential surgical morbidity. Choice of an appropriate surgical approach requires consideration of the patient's activity level, as well as the anatomic distortion that is present. In the posttraumatic situation, there is lack of agreement as to management of the distal ulna. Relative increased ulnar length and triangular fibrocartilage insufficiency make use of partial resection techniques more difficult. Osteotomy of the distal radius with or without a concomitant distal ulna procedure most nearly re-creates the preinjury situation anatomically and is seeing increasingly widespread application. It continues to be a challenging procedure from a technical standpoint. The need for procedures discussed in this review could be drastically reduced by a more aggressive approach to the initial fracture.
桡骨远端畸形愈合的治疗方法可视为一个手术选择的层级体系，其复杂性和潜在手术并发症逐渐增加。选择合适的手术方法需要考虑患者的活动水平以及存在的解剖结构畸形。在创伤后情况下，对于尺骨远端的处理尚无共识。相对增加的尺骨长度和三角纤维软骨不足使部分切除技术的应用更加困难。桡骨远端截骨术无论是否同时进行尺骨远端手术，在解剖学上最接近恢复伤前状态，且应用越来越广泛。从技术角度来看，这仍然是一个具有挑战性的手术。通过对初始骨折采取更积极的治疗方法，本综述中讨论的手术需求可能会大幅减少。
