严重桡骨远端骨折的治疗  

Treatment of severe distal radius fracture

作　　者：吴有鲁[1] 冯庆生[1] 丁彩田[1] 张勤中[1] 章武华 费爽明[1] 闻鑫高 林栋[1] 曹华[1] 何利江[1] 董海兵[1] 

机构地区：[1]杭州市余杭第二人民医院骨科,浙江杭州311121

出　　处：《中国骨伤》2006年第10期593-594,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的：探讨严重桡骨远端骨折治疗方法及临床疗效.方法：47例桡骨远端骨折,男20例,女27例;年龄45～89岁,平均67岁.按AO原则分类,根据不同的骨折类型,采用不同的治疗方法.21例（A组）采用闭合复位石膏或夹板外固定,其中A31例,Bi2例,B23例,B33例,C112例.8例（B组）采用闭合整复,多功能支架外固定（包括配合经皮克氏针固定）,A31例,B22例,C11例,C22例,C32例.6例（C组）采用切开复位T形或斜T形钢板螺钉内固定,其中B11例,B22例,Ci2例,C21例.12例（D组）切开复位钢板内固定配合多功能支架外固定,B12例,B22例,B33例,C13例,C21例,C31例.结果：按Shea评定法评估,A组（非手术组）优8例,良6例,中5例,差2例,优良率为66.7%（14/21）;B组优6例,良1例,中1例,优良率87.5%（7/8）;C组优4例,良1例,中1例;D组优8例,良2例,中2例,C、D两组优良率均为83.3%（5/6,10/12）.结论：严重桡骨远端骨折,根据AO分类的不同,手术治疗比非手术治疗有明显的优势,具体方法可根据骨折的类型不同进行选择.Objective：To explore therapeutic method and clinical effect of severe distal radialis fracture. Methods： Forty-seven distal radial fractures （ 20 males and 27 females, aged from 45 to 89 years with an average of 67 years）were treated with different methods according to different classification of fracture. Among the patients, 21 cases underwent close reduction and splinting （ group A ; A3 , B1, B2, B3 , C 1 were 1,2,3,3,12 respectively） ,8 cases underwent close reduction and multiple-power external fixation （ group B ; A3 , B2, C1 , C2, C3 were 1,2,1,2,2 respectively） ,6 cases underwent open reduction and T-shape steel plate fixation （group C;B1, B2, C1, C2 were 1,2,2,1 respectively）, 12 cases undenwent open reduction and multiple-power external fixation （group D;B1 ,B2,B3,C1,C2,C3 were 2,2,3,3,1,1 respectively）. Results：According to the criterion of Shea, 8 cases obtained excellent resuh,6 good,5 fair,2 poor,the rate of excellent and good was 66. 7% （ 14/21 ） in group A. Six cases obtained excellent result,1 good,1 fair,the rate of excellent and good was 87. 5% （7/8） in group B. In group C and D, the excellent, good, fair result were, 4,1,1 and 8,2,2 respectively, the rate of excellent and good was 83.3% （5/6,10/12）. Conelusion ：Operative treatmemt for severe distal radial fracture has the advantage over non-operative. Operative methods can be selected according to fracture type.

关 键 词：严重的桡骨远端骨折 治疗方案 

分 类 号：R683.41[医药卫生—骨科学]