目的 总结锚钉一期固定治疗桡骨远端骨折并发的三角纤维软骨复合体（triangular fibrocartilagecomplex，TFCC）损伤的临床疗效。
方法 2011年10月-2013年3月，收治9例桡骨远端骨折合并TFCC损伤患者。男6例，女3例；年龄21～56岁，平均32岁。左侧4例，右侧5例。致伤原因：交通事故伤5例，摔伤4例。受伤至手术时间5 h～10 d，平均6 d。骨折按AO分型标准： A3型5例，C1型2例，C2型2例。TFCC损伤根据Palmer分型标准均为Ⅰ B型。术中桡骨骨折复位内固定后常规检查远端尺桡关节（distal radioulnar joint，DRUJ）的稳定性，明确DRUJ不稳定后切开探查证实为TFCC损伤，行锚钉一期固定治疗。
结果 术后切口均Ⅰ期愈合。患者均获随访，随访时间12～18个月，平均13.5个月。X线片复查示，骨折对位可，内固定物位置满意，DRUJ关系正常；骨折均愈合，愈合时间6～8周，平均7.6周。末次随访时，按改良Mayo腕关节功能评分：获优6例，良3例，优良率为100%。
结论 桡骨远端骨折合并TFCC损伤时，在骨折复位内固定后行锚钉一期固定修复TFCC，能获得较满意腕关节功能。
Citation：
王炳祺, 秦文艺, 孙玉福, 万彦林, 姜文学. 锚钉一期固定治疗桡骨远端骨折并发的三角纤维软骨复合体损伤. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(9): 1183-1185. doi: 10.7507/1002-1892.20150256
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Copyright © the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
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Kirchberger MC, Unglaub F, Mühldorfer-Fodor M, et al. Update TFCC:histology and pathology, classification, examination and diagnostics. Arch Orthop Trauma Surg, 2015, 135(3):427-437.
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Scheer JH, Adolfsson LE. Patterns of triangular fibrocartilage complex (TFCC) injury associated with severely dorsally displaced extra-articular distal radius fractures. Injury, 2012, 43(6):926-932.
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Palmer AK. Triangular fibrocartilage complex lesions:a classification. J Hand Surg (Am), 1989, 14(4):594-606.
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Ruch DS, Yang CC, Smith BP. Results of acute arthroscopically repaired triangular fibrocartilage complex injuries associated with intra-articular distal radius fractures. Arthroscopy, 2003, 19(5):511-516.
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Lindau T, Adlercreutz C, Aspenberg P. Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures. J Hand Surg (Am), 2000, 25(3): 464-468.
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| 6. |
曹洪辉, 唐康来, 邓银栓, 等. 副舟骨切除结合胫后肌腱止点前 置重建治疗副舟骨源性平足症. 中国修复重建外科杂志, 2012, 26(6):686-690.
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| 7. |
Taylor CJ, Bansal R, Pimpalnerkar A. Acute distal biceps tendon rupture-a new surgical technique using a de-tensioning suture to brachialis. Injury, 2006, 37(9):838-842.
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- 1. Kirchberger MC, Unglaub F, Mühldorfer-Fodor M, et al. Update TFCC:histology and pathology, classification, examination and diagnostics. Arch Orthop Trauma Surg, 2015, 135(3):427-437.
- 2. Scheer JH, Adolfsson LE. Patterns of triangular fibrocartilage complex (TFCC) injury associated with severely dorsally displaced extra-articular distal radius fractures. Injury, 2012, 43(6):926-932.
- 3. Palmer AK. Triangular fibrocartilage complex lesions:a classification. J Hand Surg (Am), 1989, 14(4):594-606.
- 4. Ruch DS, Yang CC, Smith BP. Results of acute arthroscopically repaired triangular fibrocartilage complex injuries associated with intra-articular distal radius fractures. Arthroscopy, 2003, 19(5):511-516.
- 5. Lindau T, Adlercreutz C, Aspenberg P. Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures. J Hand Surg (Am), 2000, 25(3): 464-468.
- 6. 曹洪辉, 唐康来, 邓银栓, 等. 副舟骨切除结合胫后肌腱止点前 置重建治疗副舟骨源性平足症. 中国修复重建外科杂志, 2012, 26(6):686-690.
- 7. Taylor CJ, Bansal R, Pimpalnerkar A. Acute distal biceps tendon rupture-a new surgical technique using a de-tensioning suture to brachialis. Injury, 2006, 37(9):838-842.
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