Lindau T, Arner M, Hagberg L
Department of Orthopaedic Surgery, Lund University Hospital, Sweden.
J Hand Surg Br. 1997 Oct;22(5):638-43. doi: 10.1016/s0266-7681(97)80364-6.
We examined the frequency of associated chondral and ligament lesions in distal fractures of the radius in young adults (men 20-60 years, women 20-50 years). Fifty initially displaced fractures were examined arthroscopically. Chondral lesions were found in 16 patients (32%). All patients but one were found to have a ligamentous injury in the wrist. No major instability was found. The most frequent ligament tear was the triangular fibrocartilage complex in 39 cases (78%), with a statistical correlation to ulnar styloid fractures. The scapholunate ligament was partially or totally torn in 27 cases (54%). No correlation was found between specific fracture type and pattern of ligament injury. Chondral and ligamentous lesions were frequent and may explain poor outcomes after seemingly well-healed distal fractures of the radius. The ligament lesions should also be kept in mind when early mobilization of the distal fracture of the radius is considered.
我们研究了年轻成年人（男性20至60岁，女性20至50岁）桡骨远端骨折相关软骨和韧带损伤的发生率。对50例最初移位的骨折进行了关节镜检查。16例患者（32%）发现有软骨损伤。除1例患者外，所有患者均被发现手腕存在韧带损伤。未发现严重不稳定情况。最常见的韧带撕裂是三角纤维软骨复合体损伤，共39例（78%），与尺骨茎突骨折存在统计学相关性。舟月韧带部分或完全撕裂27例（54%）。未发现特定骨折类型与韧带损伤模式之间存在相关性。软骨和韧带损伤很常见，这可能解释了桡骨远端骨折看似愈合良好但预后不佳的原因。在考虑桡骨远端骨折早期活动时，也应牢记韧带损伤情况。
