[1]杨成△,张腾,杜杰利.桡骨远端骨折合并尺骨茎突骨折内固定术后掌倾角和尺偏角与腕关节功能的关系[J].中国中医骨伤科杂志,2026,34(04):71-78.[doi:10.20085/j.cnki.issn1005-0205.260412]
　YANG Cheng,ZHANG Teng,DU Jieli.Effect of Changes in Palmar Angle and Ulnar Declination on Wrist Function after Internal Fixation of Distal Radius Fracture Combined with Ulnar Styloid Fracture[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2026,34(04):71-78.[doi:10.20085/j.cnki.issn1005-0205.260412]
点击复制

桡骨远端骨折合并尺骨茎突骨折内固定术后掌倾角和尺偏角与腕关节功能的关系()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第34卷
期数:
2026年04期
页码:
71-78
栏目:
临床研究
出版日期:
2026-04-10

文章信息/Info

Title:
Effect of Changes in Palmar Angle and Ulnar Declination on Wrist Function after Internal Fixation of Distal Radius Fracture Combined with Ulnar Styloid Fracture
文章编号:
1005-0205(2026)04-0071-08
作者:
杨成1△; 张腾1; 杜杰利1
1沧州市中心医院(河北 沧州,061001)
Author(s):
YANG Cheng1△; ZHANG Teng1; DU Jieli1
1Cangzhou Central Hospital,Cangzhou 061001,Hebei China.
关键词:
桡骨远端骨折;  尺骨茎突骨折;  内固定术;  掌倾角;  尺偏角;  腕关节功能
Keywords:
distal radius fracture;  ulnar styloid fracture;  internal fixation;  palmar tilt angle;  radial inclination angle;  wrist joint function
分类号:
R683.41
DOI:
10.20085/j.cnki.issn1005-0205.260412
文献标志码:
A
摘要:
目的:探讨桡骨远端骨折合并尺骨茎突骨折内固定术后掌倾角和尺偏角与腕关节功能的关系。方法:选择2022年5月至2024年1月收治的116例桡骨远端骨折合并尺骨茎突骨折患者作为研究对象,根据术后12个月腕关节恢复情况将患者分为优良组(n=91)和中差组(n=25)。对比两组患者临床指标、手术指标及治疗前后掌倾角、尺偏角,Logistic回归分析腕关节功能影响因素,利用广义估计方程(GEE)分析治疗后不同关节功能患者掌倾角及尺偏角差异,绘制受试者工作特征曲线分析治疗后掌倾角、尺偏角对关节功能恢复情况的预测价值。结果:两组患者治疗前掌倾角、尺偏角差异无统计学意义(P>0.05),治疗后两组患者掌倾角、尺偏角均显著改善,差异有统计学意义(P<0.05),其中优良组患者治疗后掌倾角、尺偏角显著优于中差组,差异有统计学意义(P<0.05); 年龄、粉碎性骨折、骨质疏松、医源性软组织损伤、功能锻炼不规律、掌倾角及尺偏角均为腕关节功能恢复的独立影响因素,差异有统计学意义(P<0.05); 粉碎性骨折、骨质疏松、医源性软组织损伤及功能锻炼不规律对掌倾角和尺偏角产生显著的负向影响,差异有统计学意义(P<0.05); 受试者工作特征曲线分析显示治疗后掌倾角、尺偏角对关节功能恢复情况具有一定预测价值(曲线下面积>0.700),掌倾角和尺偏角联合预测腕关节功能曲线下面积为0.873,灵敏度、特异度分别为0.833和0.851,高于掌倾角、尺偏角单独预测效能。结论:桡骨远端骨折合并尺骨茎突骨折内固定术后掌倾角和尺偏角的恢复程度是影响腕关节功能恢复的重要因素。术后应密切关注掌倾角和尺偏角的恢复情况,并积极控制其他影响因素,以促进患者腕关节功能的恢复。
Abstract:
Objective:To investigate the effect of palmar angle and ulnar declination on wrist function after internal fixation of distal radius fractures combined with ulnar styloid fractures.Methods:A total of 116 patients with distal radius fractures combined with ulnar styloid fracture,who were between May 2022 and January 2024,were enrolled as the study participants.According to the wrist joint recovery 12 months after surgery,patients were divided into excellent group(n=91)and moderate-to-poor group(n=25).The clinical indicators,surgical indicators,palmar inclination angle,and ulnar deviation angle before and after treatment were compared between the two groups.Logistic regression analysis was conducted to identify the factors influencing wrist joint function.Generalized estimation equation(GEE)was used to analyze the differences of palmate inclination angle and ulnar deviation angle among patients with different joint functions after treatment,and receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of palmate inclination angle and ulnar deviation angle for joint function recovery after treatment.Results:Palmar inclination angle and ulnar deviation angle were not significantly different between the two groups before treatment(P>0.05),palmar inclination angle and ulnar deviation angle were significantly increased between the two groups after treatment(P<0.05),and the palmar inclination angle and ulnar deviation angle in the excellent group were significantly higher than those in the moderate-to-poor group(P<0.05).Age,comminuted fracture,osteoporosis,iatrogenic soft tissue injury,irregular functional exercise,palmar inclination angle,and ulnar deviation angle were independent factors for the recovery of wrist joint function(P<0.05).Comminuted fracture,osteoporosis,iatrogenic soft tissue injury and irregular functional exercise had significant negative effects on palmar inclination and ulnar deviation(P<0.05).ROC curve analysis showed that palmar inclination angle and ulnar deviation angle had certain predictive value(AUC>0.700)for the recovery of joint function after treatment.The combined prediction of palmar inclination angle and ulnar deviation angle AUC was 0.873,and the sensitivity and specificity were 0.833 and 0.851,respectively,which was higher than that of palmar inclination angle and ulnar deviation angle alone.Conclusion:The degree of recovery of the palmar angle and ulnar declination after internal fixation of distal radius fracture combined with an ulnar styloid fracture is an important factor affecting wrist joint functional recovery.After surgery,we should pay close attention to the recovery of palmar angle and ulnar angle,and actively control other influencing factors to promote the recovery of wrist joint function.

参考文献/References:

[1] ANDO J,TAKAHASHI T,AE R,et al.Epidemiology of distal radius fracture:a regional population-based study in Japan[J].BMC Musculoskeletal Disorders,2023,24(1):478.
[2] 郭洋,刘凯.桡骨远端骨折合并尺骨茎突骨折内固定术后掌倾角和尺偏角改变对桡骨短缩的影响[J].国际外科学杂志,2023,50(7):486-493.
[3] 杨国磊,李二虎,李洪飞,等.基于腕关节功能、肘关节功能和影像学参数探讨不同术式治疗创伤性桡骨远端骨折的疗效[J].分子影像学杂志,2023,46(2):357-361.
[4] 余刚,余利军,吴华杰.平乐郭氏正骨联合小夹板外固定对老年桡骨远端骨折患者掌倾角及腕关节功能的影响[J].中国中西医结合外科杂志,2023,29(3):322-326.
[5] MERKOW D B,DUENES M L,EGOL K A,et al.The evolution of the treatment of distal radius fractures how we got to now[J].Bulletin of the Hospital for Joint Disease,2024,82(1):77-84.
[6] OZBEN H,ULUDA(ˇoverG)S,ATAKER Y,et al.Distal radius fractures:what are the effects of ulnar styloid fracture and face-to-face rehabilitation on the functional outcome?[J].Acta Orthopaedica et Traumatologica Turcica,2023,57(6):361-365.
[7] 党幼婷,段虹昊,谢飞,等.尺骨茎突骨折类型对桡骨远端骨折治疗效果的影响研究[J].中华创伤骨科杂志,2022,24(2):168-172.
[8] 王海羽,汤立新,郭雄飞,等.内固定与外固定桡骨远端C2和C3型骨折的比较[J].中国矫形外科杂志,2021,29(8):684-688.
[9] 苏钟毅,胡宏亮,季兴华,等.尺骨茎突固定与否对桡骨远端骨折并尺骨茎突骨折患者腕关节功能影响的观察分析[J].中国药物与临床,2018,18(S1):91-92.
[10] SÜDOW H,SJÖDIN L,MELLSTRAND NAVARRO C.Validity of distal radius fracture diagnoses in the Swedish National Patient Register[J].European Journal of Medical Research,2023,28(1):335.
[11] CHHABRA A B,YILDIRIM B.Adult distal radius fracture management[J].The Journal of the American Academy of Orthopaedic Surgeons,2021,29(22):e1105-e1116.
[12] GHADDAF A A,ABDULHAMID A S,ALOMARI M S,et al.Comparison of immobilization periods following open reduction and internal fixation of distal radius fracture:a systematic review and meta-analysis[J].Journal of Hand Therapy,2023,36(1):23-32.
[13] 李伟,邵佳佳,陈多军,等.尺骨茎突骨折及其分型对桡骨远端骨折术后疗效的影响[J].临床外科杂志,2023,31(8):756-759.
[14] KIM K W,LEE C H,CHOI J H,et al.Distal radius fracture with concomitant ulnar styloid fracture:does distal radioulnar joint stability depend on the location of the ulnar styloid fracture?[J].Archives of Orthopaedic and Trauma Surgery,2023,143(2):839-845.
[15] CHA S M,SHIN H D,LEE S H,et al.Factors predictive for union of basal fracture of the ulnar styloid process after distal radial fracture fixation using a volar locking plate[J].Injury,2021,52(3):524-531.
[16] 金文,孙良业,凤晓翔,等.尺骨茎突Ⅱ型骨折对桡骨远端骨折术后腕关节功能的影响[J].西部医学,2023,35(8):1183-1187.
[17] 吴源旻,王韬,俞志兴,等.手功能康复治疗仪治疗老年患者桡骨远端骨折后掌指关节僵硬的临床观察[J].老年医学与保健,2023,29(4):798-801.
[18] 李春梅,孙洁,蓝慧,等.强化性康复护理在骨质疏松性桡骨远端骨折复位后腕关节功能恢复中的应用[J].齐鲁护理杂志,2022,28(24):1-3.
[19] 卢博,杨波,霍乐乐.桡骨远端骨折术后腕关节功能恢复不佳的高危因素[J].实用手外科杂志,2022,36(4):509-511,517.
[20] 张盼,赵庆华.掌、背侧微型钢板联合固定治疗桡骨远端粉碎性骨折[J].临床骨科杂志,2024,27(3):386-389.
[21] 赵雁波,张广峰,吴丹丹.桡骨远端骨折42例临床治疗方法及疗效[J].实用手外科杂志,2022,36(3):312-314.
[22] 郭洋,刘凯.桡骨远端骨折切开复位掌侧钢板内固定术后骨折愈合时间分布及延迟愈合的因素探讨[J].中国骨与关节杂志,2024,13(8):606-613.
[23] 魏小玉.早期康复治疗对桡骨远端骨折术后腕关节功能恢复的影响效果观察[J].中国药物与临床,2021,21(5):868-869.
(收稿日期:2025-08-06)

备注/Memo

备注/Memo:
基金项目:2025年度河北省医学科学研究课题(20251532)
△通信作者 E-mail:457305182@qq.com
更新日期/Last Update: 2026-04-15