桡骨远端骨折类型和腕不稳定关系

目的 研究桡骨远端骨折类型对腕不稳定发生的作用。方法 在160例正常腕关节测量并确定腕不稳定标准基础上,比较236例桡骨远端骨折中桡骨远端关节面不平整(52例)、桡骨明显缩短(50例)、桡骨远端关节面背倾(43例)和伴尺骨茎突骨折(65例)与无以上因素的一般骨折(63例)不稳定发生率及类型,分析以上骨折相关因素的严重程度和不稳定发生的关系。结果 伴有尺骨茎突骨折例腕不稳定发生率为47.7％,腕关节背倾例中发生率为30.2％,桡骨明显缩短例中发生率为22％,关节面不平整例中发生率为17.3％,一般骨折例中发生率为7.8％。腕不稳定例的桡骨缩短、关节面背倾和尺骨茎突骨折移位程度与无不稳定的比较有显著差异。结论 桡骨远端骨折的关节面不完整、桡骨明显缩短、关节面背倾和伴尺骨茎突骨折对腕不稳定例发生及程度有显著影响。

Relationship between types of distal radius fractures and occurrence of carpal instability

Objective To investigate the relationship between types of radius fractures and occurrence of carpal instability. Methods On the basis of measurement of radiographic index in 160 normal wrists and criteria of carpal instability, 236 distal radius fractures were studied to analyze effect of articular surface integrity, radial shortening, dorsal tilt of the radial joint surface and ulnar styloid fracture on incidence of carpal instability. Results Incidence of carpal instability was 47. 7% in distal radius fractures with ulnar styloid fracture, 30. 2% in the fractures with dorsal tilt of the joint surface, 22% in the fractures with obvious radial shortening and 17. 3% in the fractures with joint surface disruption. The incidence of carpal instability was 7.8% in distal radius fractures without above factors. The radial shortening, dorsal tilt of the joint surface and displacement of ulnar styloid fractures was significantly severer in the cases with carpal instablity than those in the cases without carpal instability. Conclusions Joint integrity, radial shortening, dorsal tilt of the joint surface and ulnar styloid fractures have significant effect on incidence and severity of carpal instability.