摘要目的:探讨桡骨远端骨折合并尺骨茎突基底部或隐窝处骨折引起急性开放性桡尺远侧关节不稳定的手术指征和治疗方法。方法:自2014年1月至2019年6月我科对13例桡骨远端骨折、合并尺骨茎突基底部或隐窝处骨折的桡尺远侧关节急性不稳定患者进行一期手术治疗，通过掌侧钢板复位固定桡骨骨折后，术中对比健侧进行桡尺远侧关节冲击试验。如果不稳定者采用固定尺骨茎突骨折或锚钉修复三角纤维软骨复合体的方式修复其骨和软组织的稳定结构，达到早期康复训练的目的。结果:术后13例患者桡骨远端骨折与尺骨茎突骨折均愈合，术后随访6～36个月。通过桡尺远侧关节冲击试验、握力、腕关节主动活动度、疼痛评分、DASH评分等综合评估，效果优良。结论:一期固定桡骨并修复累及三角纤维软骨复合体损伤的尺骨茎突骨折，有助于恢复桡尺远侧关节骨结构和软组织结构的稳定性，便于早期康复锻炼，提高急性桡尺远侧关节不稳定的疗效，减少并发症的发生。

abstractsObjective:To investigate the surgical indications and treatment of acute open distal radioulnar joint (DRUJ) instability caused by distal radius fracture combined with fracture at the base of styloid process or recess of ulna.Methods:From January 2014 to June 2019, 13 patients with acute DRUJ instability caused by distal radius fracture combined with fracture at the base of styloid process or recess of ulna were treated by one-stage operation. After the reduction and volar plate fixation of radius fracture, the DRUJ impact test was performed comparing with the contralateral side during the operation. In case of instability, the stable structure of bone and soft tissue can be repaired by fixation of ulna styloid process fracture or anchor repair of triangular fibrocartilage complex, so as to achieve the purpose of early rehabilitation training.Results:After operation, 13 patients achieved healing of the distal radius and ulnar styloid process fractures. All the patients were follow-up for 6 to 36 months. The comprehensive evaluation of the DRUJ impact test, grip strength, wrist active range of motion, pain score, DASH score showed that the clinical efficacy was good.Conclusion:The one stage fixation of radius fracture and repair of ulnar styloid process fracture involving triangular fibrocartilage complex injury is helpful to restore the stability of bone and soft tissue structure of DRUJ, facilitate early rehabilitation exercise, improve the clinical efficacy of acute DRUJ instability and reduce the incidence of complications.