Abstract:
Fractures involving the lunate facet of the distal radius (commonly called the volar ulnar corner or \"critical corner\") are often difficult to recognize radiographically. \"Lunate facet escape\" refers to the displacement of this fragment after attempted distal radius fracture closed or open reduction methods. Lunate facet escape can have severe consequences including carpal collapse with pain, instability, and arthritis. Challenges to lunate facet fixation include irregular cortical contour that makes plate fixation difficult, as well as deforming forces by inserting structures. The goal of the management of a distal radius fracture with lunate facet involvement is first identification, then adequate stabilization until osseous healing occurs. However, subsequent lunate facet escape can pose a challenging clinical and surgical dilemma. Here we discuss our preferred approach to treat lunate facet escape after distal radius fracture volar locking plating failure.
摘要:
涉及桡骨远端的月牙面骨折(通常称为掌侧尺骨角或“临界角”)通常难以通过影像学检查识别。“Lunate小面逃脱”是指在尝试闭合或切开复位方法后,该碎片的移位。Lunatefacet逃逸可能会产生严重的后果,包括腕关节塌陷和疼痛,不稳定性,和关节炎。月面固定的挑战包括不规则的皮质轮廓,使钢板固定困难,以及通过插入结构变形力。治疗桡骨远端骨折伴月关节面受累的目标是首先识别,然后足够的稳定,直到骨性愈合发生。然而,随后的月小面逃逸可能会带来具有挑战性的临床和手术困境。在这里,我们讨论了治疗桡骨远端骨折掌侧锁定钢板失败后的月小面逃逸的首选方法。