尺骨茎突基底部骨折对桡骨远端骨折内固定术后腕关节功能的影响

目的 探讨尺骨茎突基底部骨折对桡骨远端骨折术后腕关节功能及下尺桡关节稳定性的影响.方法 2007年1月-2011年12月,本院收治不稳定性桡骨远端骨折57例,其中伴有尺骨茎突基底部骨折30例（A组）,不伴有尺骨茎突骨折27例（B组）.所有患者均行前路锁定钢板固定,尺骨茎突基底部骨折不予固定.术后采用腕关节各项活动度、Gartland-Werley评分及DASH量表评估腕关节功能,通过与健侧对比判断是否存在下尺桡关节不稳.结果 57例患者均获随访,随访时间12～ 18个月.各组术后腕关节功能差异无统计学意义（P＞0. 05）.随访均未出现下尺桡关节不稳.结论 尺骨茎突基底部骨折对桡骨远端骨折术后腕关节功能及下尺桡关节不稳无明显影响.

Effect of ulnar styloid base fracture on wrist function after stable fixation of the distal radial fracture

Objective To determine whether ulnar styloid base fracture following stable fixation of distal radial fracture has any effect on wrist function or on the development of chronic distal radioulnar joint instability. Methods 57 consecutive patients who underwent surgical treatment of an unstable distal radial fracture between January 2007 and December 2011 were divided into group A with ulnar styloid base fracture （n = 30） and group B without ulnar styloid base fracture （n = 27）. All the patients in both groups received anterior locking plate fixation and were followed up for 12 - 18 months. Defined movements in wrist flexion and extension and in pronation and supination were performed after operation. Gartland - Werley score and the disabilities of the arm, shoulder and hand （DASH） score were used to evaluate the wrist function. Results There was no significant difference in wrist flexion - extension and pronation - supination between groups A and B （ P 〉 0.05 ）. No significant differences in Gartland - Werley score and DASH score were observed between groups A and B （ P 〉 0.05 ）. After fixation of fracture of distal radius, 12 cases were found to have distal radioulnar joint instability compared with the healthy contralateral joint. By temporary splint fixation for 4 weeks, no distal radioulnar joint instability was found during post - operative follow - up. Of the 12 patients with intraoperative laxity of the distal radioulnar joint, 7 patients were in the group A and 5 patients were in the group B. Intraoperative laxity of the distal radioulnar joint showed no correlation with the ulnar styloid base fracture level （ P 〉 0.05 ）. Conclusion An accompanying ulnar styloid base fracture in patients with stable fixation of distal radial fracture has no apparent adverse effect on wrist function or stability of the distal radioulnar joint.