桡骨远端骨折术后合并拇长伸肌腱断裂的临床病因分析

Clinical pathogeny analysis of extensor pollicis longus tendon rupture cases complicated with distal radius fracture after operation

关键词:  桡骨远端骨折  术后  拇长伸肌腱

Key words:  distal radius fracture  postoperative  extensor pollicis longus

摘要:

目的　探讨分析桡骨远端骨折术后合并拇长伸肌腱断裂的相关病因。方法　收集2005—2015年桡骨远端骨折术后合并拇长伸肌腱断裂患者5例，其中男2例，女3例。5例患者均为摔伤，且为闭合性骨折。均于入院3日内行掌侧入路切开复位内固定术。术后恢复期出现拇指背伸障碍，分别行对应治疗。总结患者的诊疗经过、手术过程、术中所见及术后随诊情况，分析造成桡骨远端骨折术后发生拇长伸肌腱断裂的原因。结果　术后第5个月所有患者拇指背伸功能均满意。5例桡骨远端骨折术后拇长伸肌腱断裂患者的病因分别为：1例因血运因素造成，2例患者因桡骨远端特殊解剖因素造成，1例患者因手术内固定物因素造成，1例患者因疾病、年龄等综合因素造成。结论　造成桡骨远端骨折术后合并拇长伸肌腱断裂的病因有：血运因素、解剖因素、内固定物因素、年龄因素、疾病因素等，也可能是多因素共同作用所致。

Abstract:

Objective　To investigate the pathogenesis of distal radius fractures complication with postoperative extensor pollicis longus tendon rupture.Methods　Collected 5 cases of distal radius fractures complicated with postoperative long thumb extensor tendon rupture patients who had been treated in our hospital from 2005 to 2015, among them， 2 males,3 females.All of the 5 cases were closed fractures and falls,conducted volar open reduction and internal fixation within 3 days on admission.In the postoperative recovery period,there was a thumb extension disorder,carried out the corresponding treatment respectively. Analysis of the patients' treatmeent,surgical rocedures,intraoperative and postoperative follow-up,analysis of the causes of distal radius fracture postoperative extensor pollicis longus tendon rupture.Results　 After 5 months of the operation,all of the patients were satisfied with the thumb back stretch function. The etiology of these 5 patients who have distal radius fracture with extensor pollicis longus tendon rupture were respectively as follows: 1 case was caused by blood supply factors, 2 patients were considered as special anatomy factors of distal radius, 1 patient was caused by the factors of internal fixation,1 patient because of disease,age,and other comprehensive factors.　Conclusion　The causes of distal radius fracture with postoperative extensor pollicis longus tendon rupture: blood factors, anatomic factors, internal fixation factors, age factors, disease factors, and also may be caused by different factors at the same time.