合并桡骨远端骨折的舟月分离舟月骨间韧带修补
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1.同济大学附属同济医院;2.闸北中心医院骨科

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Scapholunate interosseous ligament repair for static scapholunate dissociation associated with distal radius fracture
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1.Tongji Hospital of Tongii University, Shanghai;2.Zhabei Central Hospital, Shanghai

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    摘要:

    [目的]探讨舟月骨间韧带(Scapholunate ligament SLIL)修补治疗合并桡骨远端骨折的舟月分离(Scapholunate dissociation SLD)的疗效。[方法] 回顾2014年6月~2019年12月期间,我院14例新鲜桡骨远端骨折合并SLD的病例,切开复位内固定桡骨骨折同时修补SLIL。通过X线、腕关节活动度、握力及改良Mayo腕关节评分,评价疗效。[结果] 经过平均19.1个月随访,所有患者桡骨均骨性愈合、SLD得到纠正。术后8周与术前X线指标对比:舟月间隙、舟月角、掌倾角、桡偏角明显改善(P<0.05),尺骨变异改善不明显;术后8周与末次随访的各项X线指标,均无显著差异。末次随访时,只有患腕屈曲角度低于健侧(P<0.05),患侧腕背伸、旋前、旋后角度及手握力,与健侧无明显差异。改良Mayo评分优良率78.57%。[结论]对于新鲜合并桡骨远端骨折的SLD,复位固定桡骨的同时修补SLIL,能够取得良好的临床疗效。

    Abstract:

    [Objective] To investigate the outcomes of scapholunate interosseous ligament (SLIL) repair for scapholunate dissociation(SLD) associated with distal radius fracture. [Methods] A retrospective study was performed on 14 fresh cases with SLD associated with distal radius fractures in our hospital from June 2014 to December 2019. The fractures were treated with open reduction and internal fixation and SLIL were repaired at the same time in these patients. Clinical result was evaluated according to X-ray, wrist range of motion, grip strength and modified Mayo wrist score. [Results] After average 19.1 months follow-up, Radiuses were bony healed and the SLD was corrected in all cases. Compared with preoperative ones, the scapholunate interval,scapholunate angle, volar tilt,radial inclination at 8 weeks postoperatively were improved significant, the ulnar variance change showed no significant difference. There was no significant difference in all of the above radiologic measures between 8 weeks postoperatively and the last follow-up. At the last follow-up, the flexionrange of motion (ROM) of the affected wrist was significantly lower than that of healthy side. The extension, pronation, supination ROM and grip strength showed no significant difference between the affected wrist and the healthy side. According to the modified Mayo wrist score, the excellent or good rate was 78.57%. [Conclusion] In the fresh cases with SLD associated with distal radius fractures, a good clinical result can be obtained by reducing and fixing the fracture and repairing the SLIL.

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  • 收稿日期:2021-04-12
  • 最后修改日期:2021-07-07
  • 录用日期:2021-08-13
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