Richards R S, Bennett J D, Roth J H, Milne K
Department of Surgery, University of Western Ontario, London, Canada.
J Hand Surg Am. 1997 Sep;22(5):772-6. doi: 10.1016/S0363-5023(97)80068-8.
Arthroscopy was used to assess the soft tissue injuries associated with distal radial fractures in 118 acute intra- and extra-articular fractures. The triangular fibrocartilage complex (TFCC) was torn in 46 of 118 patients--in 35% of intra-articular fractures and in 53% of extra-articular fractures. No correlation between ulnar styloid fractures and TFCC injuries could be found. Scapholunate (SL) ligament injuries with instability were present in 21.5% of intra-articular fractures and in 6.7% of extra-articular fractures. Lunotriquetral (LT) ligament injuries with instability were present in 6.7% of intra-articular fractures. and in 13.3% of extra-articular fractures. Combined SL and LT injuries were present in 5.6% of intra-articular fracture. Preoperative radiographs correlated with TFCC injury. Patients with TFCC tears had greater shortening and dorsal angulation on the preoperative radiographs. Preoperative radiographs had no predictive value for interosseous ligament injury. Ligamentous injuries are commonly associated with both intra-articular and extra-articular distal radial fractures.
采用关节镜检查评估118例急性关节内和关节外桡骨远端骨折相关的软组织损伤。118例患者中，46例三角纤维软骨复合体（TFCC）撕裂，其中关节内骨折患者中35%出现TFCC撕裂，关节外骨折患者中53%出现TFCC撕裂。未发现尺骨茎突骨折与TFCC损伤之间存在相关性。关节内骨折患者中21.5%存在伴不稳定的舟月（SL）韧带损伤，关节外骨折患者中6.7%存在该损伤。关节内骨折患者中6.7%存在伴不稳定的月三角（LT）韧带损伤，关节外骨折患者中13.3%存在该损伤。关节内骨折患者中5.6%存在SL和LT联合损伤。术前X线片与TFCC损伤相关。TFCC撕裂的患者术前X线片上的短缩和背侧成角更明显。术前X线片对骨间韧带损伤无预测价值。韧带损伤通常与关节内和关节外桡骨远端骨折均相关。
