| Objective:Radial lateral displacement of distal radius fractures will be lead to damaged to the triangular fibrocartilage complex,which in turn affect the stability of the distal radioulnar joint(DRUJ).To evaluate the effect of radial displacement in distal radius fracture on the stability of DRUJ by imaging and physical examinations in this study.the patients with distal radius fracture were evaluated by the degree of radial displacement and the wrist function score to provide theoretical basis for clinical operation.Methods:From November 2016 to September 2018,there are 60 patients in our group,22 males and 38 females with distal radius fractures were analyzed and selected.Age 26 to 67 years old,the average age is 41 years old.There were 29 cases with ulnar styloid fracture and 31 cases without ulnar styloid fracture.All the distal fracture segments were displaced radially and dorsally.According to the X-ray,the displacements was measured in groups A,B and C.In group A,13 cases(3 cases with ulnar styloid fracture)the displacement was less than 2mm,.In group B,20 cases(8 cases with ulnar styloid fracture),the displacement was between 2mm and 4mm.In group C,27 cases(18 cases with ulnar styloid fracture)the displacement was larger than 4mm.Among them,15 patients(with ulnar styloid fracture)with instability of the distal radioulnar joint under intraoperative physical examination were divided into two groups,the patients in one group were treated by steel wire "8" to fix the ulnar styloid during operation,and in the other group,we did not fix the ulnar styloid during operation.The effect of displacement of distal radius fracture on ulnar styloid and the effect of ulnar styloid fracture on the stability of distal radioulnar joint were analyzed.The degree of radial displacement of distal radial fractures and the effect of ulnar styloid fractures on the stability of the distal radioulnar joint were evaluated according to the postoperative follow-up patients' wrist function score.All the 60 patients selected were treated with Henry approach for distal radial fracture with open reduction and plate fixation.Results:1.The relationship between radial displacement degree of distal radius fractures and DRUJ stability:there is no statistical significance that displacement degree of distal radius fractures between less 2mm and 2mm-4mm(P>0.05);When the displacement degree of distal radius fracture between greater than 4mm and less than 4mm,the difference was statistically significant(P<0.05).2.The relationship between ulnar styloid fractures and DRUJ stability:among 29 patients with ulnar styloid fractures,20 were associated with DRUJ instability,while among 31 patients without ulnar styloid fractures,8 were associated with DRUJ instability,and the difference was statistically significant(P<0.05).3.The relationship between the degree of distal radius fracture displacement and ulnar styloid fractures:there is no statistical significance that displacement degree of distal radius fractures between less 2mm and 2mm-4mm(P>0.05);When the displacement degree of distal radius fracture between greater than 4mm and less than 4mm,the difference was statistically significant(P<0.05).4.According to the follow-up results,the results of the two groups were as follows:when the current DRUJ was unstable,the effect of fixation of the DRUJ on wrist function was statistically significant between the two groups(P<0.05).Conclusion:1.When the radial displacement degree of distal radial fracture is greater than 4mm,the possibility of affecting the stability of the DRUJ is significantly increased due to the obvious damage to the stable structure of the DRUJ.2.Radial displacement of distal radial fractures greater than 4mm was associated with an increased incidence of ulnar styloid fractures3.When the radial displacement of distal radial fracture is greater than 4mm,ulnar styloid fractures are positively correlated with the stability of DRUJ,suggesting that clinical treatment is required. |
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