- 作者：Johan H. Scheer ; Johan.Scheer@lio.se ; Lars E. Adolfsson
- 关键词：Distal radius fractures ; Triangular fibrocartilage complex ; Wrist injury ; Pathomechanisms ; Injury patterns
- 刊名：Injury
- 出版年：2012
- 期刊代码：120_00201383
- 类别：med
- 出版时间：June, 2012
- 卷：43
- 期：6
- 页码：926-932
- 文件大小：1111 K
Summary
Purpose
The aim of the study was to examine triangular fibrocartilage (TFCC) injury patterns associated with unstable, extra-articular dorsally displaced distal radius fractures.Methods
Twenty adult patients with an Arbeitsgemeinschaft f眉r Osteosynthesefragen (AO), type A2 or A3, distal radius fracture with an initial dorsal angulation greater than 20掳 were included. Nine had a tip fracture (distal to the base) of the ulnar styloid and 11 had no such fracture. They were all openly explored from an ulnopalmar approach and TFCC injuries were documented. Eleven patients also underwent arthroscopy and intra-articular pathology was recorded.
Results
All patients had TFCC lesions of varying severity, having an extensor carpi ulnaris subsheath avulsion in common. Eighteen out of 20 also displayed deep foveal radioulnar ligament lesions, with decreasingly dorsal fibres remaining. The extent of this foveal injury could not be appreciated by radiocarpal arthroscopy.
Conclusions
Severe displacement of an extra-articular radius fracture suggests an ulnar-sided ligament injury to the TFCC. The observed lesions concur with findings in a previous cadaver study. The lesions follow a distinct pattern affecting both radioulnar as well as ulnocarpal stabilisers.