[1]吴冀,张亚弟.合并尺骨茎突骨折对桡骨远端骨折患者桡尺远侧关节功能影响的Meta分析[J].中医正骨,2021,33(01):34-37.
 WU Ji,ZHANG Yadi.Effects of ulnar styloid fracture on function of distal radioulnar joint in patient with distal radius fracture:a meta analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(01):34-37.
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合并尺骨茎突骨折对桡骨远端骨折患者桡尺远侧关节功能影响的Meta分析()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年01期
页码:
34-37
栏目:
文献研究
出版日期:
2021-01-20

文章信息/Info

Title:
Effects of ulnar styloid fracture on function of distal radioulnar joint in patient with distal radius fracture:a meta analysis
作者:
吴冀张亚弟
(宁波大学医学院,浙江 宁波 315211)
Author(s):
WU JiZHANG Yadi
Ningbo University School of Medicine,Ningbo 315211,Zhejiang,China
关键词:
桡骨骨折 尺骨茎突骨折 桡尺远侧关节 Meta分析 系统评价
Keywords:
radius fractures ulnar styloid fractures distal radioulnar joint meta-analysis systematic review
摘要:
目的:评价合并尺骨茎突骨折对桡骨远端骨折患者桡尺远侧关节功能的影响。方法:计算机检索PubMed、Embase、Cochrance library、中国知网、万方数据库中所有对比合并或不合并尺骨茎突骨折的桡骨远端骨折患者桡尺远侧关节功能的随机对照或非随机对照临床试验文献,治疗方法为切开复位掌侧钢板螺钉内固定或跨关节的外固定架固定。检索时限为建库至2019年8月31日。筛选文献、提取数据并评价纳入研究的偏倚风险后,采用Revman5.3软件进行Meta分析。结果:共纳入5篇文献。Meta分析结果显示,合并和不合并尺骨茎突骨折患者(尺骨茎突骨折组和无尺骨茎突骨折组)的腕关节屈曲活动度、背伸活动度比较,组间差异均无统计学意义[屈曲活动度:P=0.850,I2=0%; WMD=-0.05,95%CI(-1.99,1.88),P=0.960。背伸活动度:P=0.990,I2=0%; WMD=-0.67,95%CI(-1.35,2.68),P=0.520]; 2组患者前臂旋前活动度、前臂旋后活动度比较,组间差异均无统计学意义[前臂旋前活动度:P=0.090,I2=51%; WMD=-1.56; 95%CI(-4.64,1.53),P=0.320。前臂旋后活动度:P=0.620,I2=0%; WMD=-0.39,95%CI(-2.19,1.40),P=0.670]; 2组患者的上肢功能障碍评分比较,差异无统计学意义[P=0.270,I2=19%; WMD=3.72,95%CI(-0.20,7.65),P=0.060]。结论:现有的证据表明,合并尺骨茎突骨折不会对桡骨远端骨折患者桡尺远侧关节功能产生影响。
Abstract:
To evaluate the effects of ulnar styloid fracture on distal radioulnar joint(DRUJ)function in patient with distal radius fracture.Methods:All articles about randomized controlled trial(RCT)and non-RCT comparing DRUJ function of distal radius fracture patients with ulnar styloid fractures(ulnar styloid fracture group)and DRUJ function of distal radius fracture patients without ulnar styloid fractures(non-ulnar styloid fracture group)that published at home and abroad included from database establishing to August 31,2019 were retrieved from PubMed,Embase,Cochrance library,China national knowledge internet and WanFang Database through computer.The patients were treated with open reduction and volar plate and screw internal fixation or frame external fixation across the wrist.The articles were screened and the information was extracted.The risk of bias of included researches in the articles was assessed and a Meta-analysis was conducted by using Revman5.3 software.Results:Five articles were included in the final analysis.The results of Meta-analysis demonstrated that there was no statistical difference in wrist palmar flexion range of motion(ROM)and wrist dorsiflexion ROM between ulnar styloid fracture group and non-ulnar styloid fracture group(palmar flexion ROM:P=0.850,I2=0%; WMD=-0.05,95%CI(-1.99,1.88),P=0.960.dorsiflexion ROM:P=0.990,I2=0%; WMD=-0.67,95%CI(-1.35,2.68),P=0.520).There was no statistical difference in forearm pronation ROM and forearm supination ROM between ulnar styloid fracture group and non-ulnar styloid fracture group(forearm pronation ROM:P=0.090,I2=51%; WMD=-1.56; 95%CI(-4.64,1.53),P=0.320.forearm supination ROM:P=0.620,I2=0%; WMD=-0.39,95%CI(-2.19,1.40),P=0.670).There was no statistical difference in the disabilities of the arm,shoulder and hand(DASH)scores between ulnar styloid fracture group and non-ulnar styloid fracture group(P=0.270,I2=19%; WMD=3.72,95%CI(-0.20,7.65),P=0.060).Conclusion:Available evidences suggest that the ulnar styloid fracture has no effects on DRUJ function in patient with distal radius fracture.

参考文献/References:

[1] STIRLING E R B,JOHNSON N A,DIAS J J.Epidemiology of distal radius fractures in a geographically defined adult population[J].J Hand Surg Eur Vol,2018,43(9):974-982.
[2] LINDAU T,HAGBERG L,ADLERCREUTZ C,et al.Distal radioulnar instability is an independent worsening factor in distal radial fractures[J].Clin Orthop Relat Res,2000(376):229-235.
[3] LINDAU T,ADLERCREUTZ C,ASPENBERG P.Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures[J].J Hand Surg Am,2000,25(3):464-468.
[4] 梁鼎天,黄金兰,韶红,等.尺骨茎突骨折分型与固定对桡骨远端骨折后腕关节功能的影响[J].中华创伤骨科杂志,2014,16(6):541-543.
[5] YILMAZ S,CANKAYA D,KARAKUS D.Ulnar styloid fracture has no impact on the outcome but decreases supination strength after conservative treatment of distal radial fracture[J].J Hand Surg Eur Vol,2015,40(8):872-873.
[6] GOGNA P,SELHI H S,MOHINDRA M,et al.Ulnar styloid fracture in distal radius fractures managed with volar locking plates:to fix or not?[J].J Hand Microsurg,2014,6(2):53-58.
[7] CHEN Y X,ZHENG X,SHI H F,et al.Will the untreated ulnar styloid fracture influence the outcome of unstable distal radial fracture treated with external fixation when the distal radioulnar joint is stable[J].BMC Musculoskelet Disord,2013,14:186.
[8] BELLOTI J C,MORAES V Y,ALBERS M B,et al.Does an ulnar styloid fracture interfere with the results of a distal radius fracture?[J].J Orthop Sci,2010,15(2):216-222.
[9] KIM J K,YUN Y H,KIM D J,et al.Comparison of united and nonunited fractures of the ulnar styloid following volar-plate fixation of distal radius fractures[J].Injury,2011,42(4):371-375.
[10] MAY M M,LAWTON J N,BLAZAR P E.Ulnar styloid fractures associated with distal radius fractures: incidence and implications for distal radioulnar joint instability[J].J Hand Surg Am,2002,27(6):965-971.
[11] 赵亮,王宝军,李亚东,等.尺骨茎突骨折及分型对桡骨远端骨折术后临床疗效的随访研究[J].北京大学学报(医学版),2011,43(5):675-680.
[12] PLOEGMAKERS J,THE B,WANG A,et al.Supination and pronation strength deficits persist at 2-4 years after treatment of distal radius fractures[J].Hand Surg,2015,20(3):430-434.
[13] SAWADA H,SHINOHARA T,NATSUME T,et al.Clinical effects of internal fixation for ulnar styloid fractures associated with distal radius fractures:a matched case-control study[J].J Orthop Sci,2016,21(6):745-748.
[14] KAZEMIAN G H,BAKHSHI H,LILLEY M,et al.DRUJ instability after distal radius fracture:a comparison between cases with and without ulnar styloid fracture[J].Int J Surg,2011,9(8):648-651.
[15] SUZUKI M,KURIMOTO S,SHINOHARA T,et al.Development and validation of an illustrated questionnaire to evaluate disabilities of the upper limb[J].J Bone Joint Surg Br,2010,92(7):963-969.
[16] LINDAU T,ARNER M,HAGBERG L.Intraarticular lesions in distal fractures of the radius in young adults.A descriptive arthroscopic study in 50 patients[J].J Hand Surg Br,1997,22(5):638-643.
[17] HAUCK R M,SKAHEN J 3rd,PALMER A K.Classification and treatment of ulnar styloid nonunion[J].J Hand Surg Am,1996,21(3):418-422.
[18] 朱先任,李东亚,郑欣,等.桡骨远端骨折合并尺骨茎突骨折的治疗进展[J].中华骨与关节外科杂志,2019,12(1):62-67.
[19] REICHL M,PIATEK S,ADOLF D,et al.Unrepaired fracture of the styloid process of the ulna:not a bad treatment result at distal radius fracture[J].Unfallchirurg,2011,114(12):1099-1104.
[20] 李晓,侯忠军,于胜军,等.探讨具有手术指征的特殊类型的尺骨茎突骨折[J].实用手外科杂志,2017,31(1):108-109.
[21] FUJITANI R,OMOKAWA S,AKAHANE M,et al.Predictors of distal radioulnar joint instability in distal radius fractures[J].J Hand Surg Am,2011,36(12):1919-1925.
[22] ALMEDGHIO S,ARSHAD M S,ALMARI F,et al.Effects of ulnar styloid fractures on unstable distal radius fracture outcomes:a systematic review of comparative studies[J].J Wrist Surg,2018,7(2):172-181.
[23] KIM J K,KIM J O,KOH Y D.Management of distal ulnar fracture combined with distal radius fracture[J].J Hand Surg Asian Pac Vol,2016,21(2):155-160.
[24] SACHAR K.Ulnar-sided wrist pain:evaluation and treatment of triangular fibrocartilage complex tears,ulnocarpal impaction syndrome,and lunotriquetral ligament tears[J].J Hand Surg Am,2012,37(7):1489-1500.
[25] WIJFFELS M M,KEIZER J,BUIJZE G A,et al.Ulnar styloid process nonunion and outcome in patients with a distal radius fracture:a meta-analysis of comparative clinical trials[J].Injury,2014,45(12):1889-1895.

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备注/Memo

备注/Memo:
通讯作者:吴冀 E-mail:471425793@qq.com
更新日期/Last Update: 2021-01-20