桡骨远端骨折掌侧锁定钢板术后尺桡比、侧位桡骨月骨角与桡骨高度丢失的关系

李兴军; 孙君军; 郑波; 张俊; 菅志飞; 卓翔

doi:10.11659/jjssx.07E024005

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桡骨远端骨折掌侧锁定钢板术后尺桡比、侧位桡骨月骨角与桡骨高度丢失的关系

临床研究 | 更新时间：2025-06-17

- 桡骨远端骨折掌侧锁定钢板术后尺桡比、侧位桡骨月骨角与桡骨高度丢失的关系
- Relationship between radial-ulnar ratio,lateral lunate angle of radius and height loss of radius after palmar locking plate surgery for distal radius fractures
- 局解手术学杂志 2025年34卷第6期页码：505-511
- 作者机构：
  
  1.湖北医药学院附属国药东风总医院急症创伤外科，湖北十堰 442000
  2.湖北医药学院附属国药东风总医院烧伤整形外科，湖北十堰 442000
- 作者简介：
  
  卓翔，E-mail：1033188939@qq.com
- 基金信息：
  
  湖北省卫生健康科研基金资助(WJ2019F069)
- DOI：10.11659/jjssx.07E024005
  中图分类号： R683.4
- 收稿日期：2024-07-01，
  
  纸质出版日期：2025-06-25
- 稿件说明：
移动端阅览
李兴军,孙君军,郑波等.桡骨远端骨折掌侧锁定钢板术后尺桡比、侧位桡骨月骨角与桡骨高度丢失的关系[J].局解手术学杂志,2025,34(06):505-511.

LI Xing-jun,SUN Jun-jun,ZHENG Bo,et al.Relationship between radial-ulnar ratio,lateral lunate angle of radius and height loss of radius after palmar locking plate surgery for distal radius fractures[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(06):505-511.
李兴军,孙君军,郑波等.桡骨远端骨折掌侧锁定钢板术后尺桡比、侧位桡骨月骨角与桡骨高度丢失的关系[J].局解手术学杂志,2025,34(06):505-511. DOI： 10.11659/jjssx.07E024005.

LI Xing-jun,SUN Jun-jun,ZHENG Bo,et al.Relationship between radial-ulnar ratio,lateral lunate angle of radius and height loss of radius after palmar locking plate surgery for distal radius fractures[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(06):505-511. DOI： 10.11659/jjssx.07E024005.

摘要

目的

探讨桡骨远端骨折掌侧锁定钢板内固定术后尺桡比、侧位桡骨月骨角改变与桡骨高度丢失的关系。

方法

选取2020年3月至2023年9月于我院采用掌侧锁定钢板内固定治疗的桡骨远端骨折患者158例。根据术后桡骨丢失高度，分为桡骨未丢失组（41例，

2 mm）、桡骨轻中度丢失组（32例，2~5 mm）与桡骨重度丢失组（85例，

5 mm），比较3组患者的临床资料。多因素

Logistic

回归分析影响桡骨高度丢失的危险因素。局部加权回归散点平滑法（LOWESS）分析连续变量二维曲线关系。限制性立方样条（RCS）及阈值效应分析尺

桡比、侧位桡骨月骨角与术后桡骨高度丢失的关系。

结果

桡骨重度丢失组患者的年龄显著大于桡骨未丢失组与桡骨轻中度丢失组（

0.05），桡骨轻中度丢失组患者的年龄显著大于桡骨未丢失组（

0.05）；女性、合并骨质疏松与骨折分型C型患者更易出现桡骨高度丢失（

0.05）。3组患者术后3、6个月的患者自我评价腕关节问卷（PRWE）评分、肩臂手残疾问卷表（DASH）评分、背伸、掌曲、尺偏、桡偏、尺桡比、侧位桡骨月骨角比较，差异均有统计学意义（

0.001）。以年龄、性别、骨质疏松、骨折分型、PRWE评分、DASH评分、背伸、掌曲、尺偏、桡偏为结果建立的预测模型一与以年龄、性别、骨质疏松、骨折分型、PRWE评分、DASH评分、背伸、掌曲、尺偏、桡偏、尺桡比、侧位桡骨月骨角为结果建立的预测模型二进行

Hosmer

Lemeshow

检验，均显示有良好的拟合优度。LOWESS分析显示，年龄、PRWE评分、DASH评分、背伸、掌曲、尺偏、桡偏、尺桡比、侧位桡骨月骨角与桡骨丢失高度均具有一定的非线性关系。RCS与阈值效应分析表明，尺桡比≥13.254的桡骨远端骨折患者术后桡骨丢失的概率随尺桡比的增大而升高（

0.001）；侧位桡骨月骨角≤11.068°的桡骨远端骨折患者术后桡骨丢失的概率随侧位桡骨月骨角的增加而降低（

0.001）。

结论

桡骨远端骨折掌侧锁定钢板内固定术后尺桡比与桡骨高度丢失呈正相关，侧位桡骨月骨角与桡骨高度丢失呈负相关。

Abstract

Objective

To investigate the relationship between the radial-ulnar ratio，lateral lunate angle of radius and height loss of radius after palmar locking plate internal fixation for distal radius fractures.

Methods

A total of 158 patients with distal radius fractures treated with palmar locking plate internal fixation in our hospital from March 2020 to September 2023 were selected. According to the height of radius loss after operation，the patients were divided into non-radius loss group （41 cases，

2 mm），mild to moderate radius loss group （32 cases，2 to 5 mm） and severe radius loss group （85 cases，

5 mm），and the clinical data of patients in the three groups were compared. Multivariate

Logistic

regression analysis was used to analyze the risk factors affecting height loss of radius. Locally weighted scatterplot smoothing （LOWESS） method was used to analyze the two-dimensional curve relationship of continuous variables. Restricted cubic spline （RCS） and threshold effect were used to analyze the relationship between the radial-ulnar ratio，later

al lunate angle of radius and height loss of radius after operation.

Results

The age of patients in the severe radius loss group was significantly higher than those in the non-radius loss group and the mild to moderate radius loss group （

0.05），and the age of patients in the mild to moderate radius loss group was significantly higher than that in the non-radius loss group （

0.05）.Female patients and patients with osteoporosis and fracture type C were more likely to have height loss of radius （

0.05）. There were significant differences in patient-rated wrist evaluation （PRWE） score，disabilities of the arm，shoulder and hand （DASH） score，dorsal extension，palmar curvature，ulnar deviation，radial deviation，radial-ulnar ratio，and lateral lunate angle of radius of patients at 3 and 6 months after operation among three groups（

0.001）. The first prediction model based on age，gender，osteoporosis，fracture type，PRWE score，DASH score，dorsal extension，palmar curvature，ulnar deviation，and radial deviation and the second prediction model based on age，gender，osteoporosis，fracture type，PRWE score，DASH score，dorsal extension，palmar curvature，ulnar deviation，radial deviation，radial-ulnar ratio，and lateral lunate angle of radius were subjected to

Hosmer-Lemeshow

test showed good goodness of fit. LOWESS analysis showed that age，PRWE score，DASH score，dorsal extension，palmar curvature，ulnar deviation，radial deviation，radial-ulnar ratio，and lateral lunate angle of radius had a certain nonlinear relationship with the height loss of radius. RCS and threshold effect analysis showed that the probability of postoperative radius loss increased with the increase of radial-ulnar ratio in patients with distal radius fractures and radial-ulnar ratio ≥ 13.254 （

0.001）. The probability of postoperative radius loss decreased with the increase of the lateral lunate angle of radius in patients with dist

al radius fractures and lateral lunate angle of radius ≤ 11.068° （

0.001）.

Conclusion

There was a positive correlation between the radial-ulnar ratio and the height loss of radius，and a negative correlation between the lateral lunate angle of radius and the height loss of radius after palmar locking plate internal fixation for distal radius fractures.

关键词

Keywords

references

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