Strehle J, Gerber C
Department of Orthopaedic Surgery, University of Bern Inselspital, Switzerland.
Clin Orthop Relat Res. 1993 Aug(293):240-5.
Nineteen Galeazzi fracture-dislocations were reviewed clinically and roentgenographically at an average of 83 months after open reduction and internal fixation. Radiographic observation of fracture reduction was correlated with clinical results. Patients with anatomic fracture reduction had minimal sequelae and better or equal functional results than patients with imperfect reduction. Manual laborers had no weakness, but nonmanual laborers showed significant deficits in supination strength. Concomitant fractures of the wrist, the hand, or both were associated with significant pronation weakness. The volar approach was associated with a significant deficit of flexion/extension range of motion (ROM). Attention was focused on distal radioulnar joint (DRUJ) function and pain. Distal radioulnar joint function was fully restored by open reduction and internal fixation of the radius and indirect anatomic reduction and functional aftercare of the DRUJ in 16 cases. Open revision, repair of the triangular fibrocartilage complex (TFCC), and immobilization of the wrist are not necessary if anatomic reduction of the joint is obtained by indirect means such as open reduction and internal fixation of the radius.
对19例盖氏骨折脱位患者在切开复位内固定术后平均83个月进行了临床和影像学检查。骨折复位的影像学观察与临床结果相关。解剖复位的患者后遗症最少，功能结果优于或等同于复位不佳的患者。体力劳动者无肌力减弱，但非体力劳动者旋后力量有明显不足。腕部、手部或两者同时发生的骨折与明显的旋前无力相关。掌侧入路与屈伸活动范围（ROM）明显不足有关。重点关注下尺桡关节（DRUJ）功能和疼痛。16例患者通过桡骨切开复位内固定及DRUJ间接解剖复位和功能康复，下尺桡关节功能完全恢复。如果通过桡骨切开复位内固定等间接方法实现关节解剖复位，则无需进行切开翻修、三角纤维软骨复合体（TFCC）修复及腕关节固定。
