urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.25.1.109BMZIEVurmj-2093Research ArticleЛитературные обзоры | Literature reviewsLiterature reviewsСовременные подходы к диагностике и лечению переломов дистального метаэпифиза лучевой кости, ассоциированных с повреждением капсульно-связочного аппарата: обзор литературыModern Approaches to the Diagnosis and Treatment of Distal Radius Fractures Associated with Capsular-Ligamentous Injuries: A Literature Reviewhttps://orcid.org/0009-0007-6433-3735БыркэИ. Д.ByrkeI. D.

Иван Дмитриевич Быркэ — травматолог-ортопед Центра реконструктивной микрохирургии кисти 

Тюмень 

Ivan D. Byrke — Orthopedic and Trauma Surgeon of the Center for Reconstructive Hand Microsurgery 

Tyumen 

handsurgery72@yandex.ruhttps://orcid.org/0000-0002-6621-9449СергеевК. С.SergeevK. S.

Константин Сергеевич Сергеев — доктор медицинских наук, профессор, заведующий кафедрой травматологии и ортопедии с курсом ВПХ 

Тюмень

Konstantin S. Sergeev — Doctor of Sciences (Medicine), Professor, Head of the Department of Traumatology and Orthopedics with a Course of Emergency Surgery 

Tyumen 

sergeev.trauma@inbox.ruhttps://orcid.org/0000-0002-8725-4155МалишевскийВ. М.MalishevskiiV. M.

Владимир Михайлович Малишевский — руководитель травматологического центра 

Тюмень 

Vladimir M. Malishevskii — Head of the Trauma Center 

Tyumen 

mvm9233@yandex.ruАлиеваО. Р.AlievaO. R.

Ольга Руслановна Алиева — студент института клинической медицины 

Тюмень 

Olga R. Alieva — Specialist’s Degree Student of the Institute of Clinical Medicine 

Tyumen 

Областная клиническая больница № 2РоссияTyumen Regional Clinical Hospital No. 2Russian FederationТюменский государственный медицинский университетРоссияTyumen State Medical UniversityRussian Federation202627022026251109–128Copyright © Быркэ И.Д., Сергеев К.С., Малишевский В.М., Алиева О.Р., 20262026Быркэ И.Д., Сергеев К.С., Малишевский В.М., Алиева О.Р.Byrke I.D., Sergeev K.S., Malishevskii V.M., Alieva O.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/2093Введение

Введение. Переломы дистального метаэпифиза лучевой кости (ДМЭЛК) часто сочетаются с повреждениями связок кистевого сустава (TFCC, SLL). Эти сочетанные повреждения нередко остаются недиагностированными, приводя к хронической боли и дисфункции. Цель обзора — систематизация современных данных по диагностике и лечению переломов ДМЭЛК, ассоциированных с повреждением связок.

Материалы и методы

Материалы и методы. Проведен систематический поиск литературы (2000–202) в базах PubMed, Scopus, Web of Science, eLibrary.ru по ключевым словам, связанным с переломами ДМЭЛК и повреждениями связок. Критериям соответствовало 73 публикации (клинические исследования, обзоры, руководства). Качество исследований оценивалось по стандартным шкалам.

Результаты и обсуждение

Результаты и обсуждение. Установлено, что повреждения связок сопутствуют 20–80 % внутрисуставных переломов ДМЭЛК. «Золотым стандартом» остеосинтеза является внутренняя фиксация волярной блокирующей пластиной. Артроскопически ассистированные методики позволяют достичь анатомической репозиции и одновременно восстановить связки. Акцентирована роль ранней контролируемой реабилитации.

Выводы

Выводы. Успех лечения зависит от комплексного подхода: точной диагностики (магнитно-резонансная томография, артроскопия), анатомического стабильного остеосинтеза, одновременного восстановления связок и ранней индивидуальной реабилитации. Перспективны разработка интегрированных классификаций и внедрение малоинвазивных артроскопических технологий. 

Introduction

Introduction. Distal radius fractures (DRF) are often combined with injuries to the ligaments of the wrist joint (TFCC, SLL). These combined injuries frequently remain undiagnosed, leading to chronic pain and dysfunction. The purpose of this review is to systematize current data on the diagnosis and treatment of DRF fractures associated with ligament injuries.

Materials and methods

Materials and methods. A systematic literature search (2000–2024) was conducted in the PubMed, Scopus, Web of Science, and eLibrary.ru databases using keywords related to DMER fractures and ligament injuries. 73 publications (clinical studies, reviews, guidelines) met the inclusion criteria. The quality of the studies was assessed using standard scales.

Results and discussion

Results and discussion. It was found that ligament injuries accompany 20–80% of intra-articular DRF fractures. The “gold standard” for osteosynthesis is internal fixation with a volar locking plate. Arthroscopically-assisted techniques allow for anatomical reduction and simultaneous ligament repair. The role of early controlled rehabilitation is emphasized.

Conclusions

Conclusions. Successful treatment depends on a comprehensive approach: accurate diagnosis (magnetic resonance imaging, arthroscopy), anatomical stable osteosynthesis, simultaneous restoration of ligaments, and early individualized rehabilitation. Promising directions include the development of integrated classifications and the implementation of minimally invasive arthroscopic technologies. 

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The authors declare that there are no conflicts of interest present.