尺骨茎突解剖特点与骨折分型及治疗方法

目的　根据尺骨茎突解剖特点探讨骨折分型与手术治疗方法。 方法 依据腕尺侧副韧带及三角软骨盘在尺骨茎突上的不同止点，将尺骨茎突骨折分为尖端骨折（Ⅰ型）及基底部骨折（Ⅱ型），按骨折损伤分型分别采用克氏针结合钢丝法、微型螺钉、细钢丝或可吸收线、克氏针等手术方法进行修复。结果 106例患者获得8～42个月（平均15个月）随诊，骨折均获愈合。腕关节功能评定采用Garland和Werley评分法进行评定，优76例，良22例，可6例，差2例。优良率为92.4％。2例尺骨茎突骨折合并桡骨远端骨折，桡骨骨折内固定后，骨折位置丢失，出现短缩畸形，致腕尺侧疼痛，3例固定尺骨茎突骨折之钢丝断裂。 结论 根据尺骨茎突解剖特点对骨折分型，明确受伤发病机制，依据骨折类型采用不同手术方法，对骨折有效、稳定固定，减少并发症出现，允许较早功能锻炼，在骨折愈合及腕关节功能恢复方面有满意的疗效。

The anatomical features,fracture types and treatment of ulnar styloid process

Objective　To investigate fracture type and surgical　treatment of ulnar styloid process according to its anatomic features.　Methods　Based on different attachment points of ulnar collateral ligament(UCL) and　triangular cartilage plate on ulnar styloid process, the fracture of ulnar styloid process were divided into tip fracture (typeⅠ) and base fracture (typeⅡ) . based on fracture type, special surgical methods were performed: Kirschner wire combined with steel wire, mini-screw, fine steel wire or absorptive thread, Kirschner and other surgical methods.　Results　106 patients were followed up about 8-42 months, averagely 15 months. All patients healed well. According to the Garland and Werley score, 76 cases were excellent, 22 good, 6 fair and 2 poor, with the excellent and good rates of 92.4%. 2 cases suffered from ulnar styloid fracture combined with distal radial fractures, received rigid internal fixation. However, fracture position lost and resulted little deformity and the pain of ulnar wrist. Wire breakage appeared in 3 cases.　Conclusions　detailed understanding of anatomical features, accurate judging of fracture type, suitable surgical fixation, and early functional exercises, are favorable for functional recovery of wrist fractures.