陈旧性Barton骨折的治疗  

Treatment of old Barton＇ s fracture

作　　者：孔志刚[1] 郭永传[1] 邵新中[1] 张志国[1] 于涛[1] 赵振英[1] 

机构地区：[1]河北医科大学第三医院骨伤科,石家庄050051

出　　处：《中华手外科杂志》2008年第2期78-81,共4页Chinese Journal of Hand Surgery

摘　　要：目的分析陈旧性Barton骨折的原因，探讨其检查与处理方法。方法对16例陈旧性Barton骨折（掌侧骨折11例，背侧骨折5例），通过X线片检查并结合CT检查确定骨折的类型、关节面的移位程度和腕关节脱位程度。11例掌侧骨折采用掌桡侧切口T型金属板固定，5例背侧骨折采用桡骨远端背外侧切口有限内固定加外固定架固定。结果术后随访时间为10～36个月，平均12．5个月。X线片显示骨折全部愈合，腕关节面掌倾角为10°～15°，平均11．3°；尺偏角16°～25°，平均20°；桡骨轴向无短缩。按Mehara功能评价：优13例，良2例，可1例；优良率为93．8％。结论切开复位内固定术是治疗陈旧性Barton骨折的一种积极而有效的方法。CT检查对Barton骨折的诊断、了解关节面的移位情况、确定手术复位及固定可靠程度有一定的临床意义。Objective To analyze the etiology of old Barton＇ s fractures and discuss the diagnostis strategies and treatment options. Methods Sixteen cases of old Barton＇ s fracture （ 11 cases of volar fractures and 5 cases of dorsal fractures） were involved. Plain X-ray examines were combined with CT scan to determine type of the fractures, displacement of joint surfaces and the severity of wrist joint dislocation. Eleven cases of volar Barton＇ s fractures were fixed with T-shaped metallic plate via a volar-radial approach. Five cases of dorsal Barton fractures were treated with limited internal fixation combined with external fixator via a distal dorsolateral incision. Results All 16 patients were followed-up for 10 to 36 months postoperatively. Bone union was seen in all cases. The volar tilting angle was 10° -15°（ average 11.3°）. The ulnar inchning angle was 16° -25°（ average 20°）. There was no shortening of the radius. According to Mehara＇ s evaluation for volar Barton＇ s fractures, 15 cases （93. 8% ） had obtained satisfying results （excellent in 13 cases, good in 2 cases, fare in 1 case）. Conclusions Open reduction and internal fixation is an effective method to treat old Barton＇s fractures. CT scan is helpful in revealing fracture details, displaying joint surface displacement, and judging the accuracy of surgical reduction and fixation.

关 键 词：骨折 骨折固定术 治疗结果 

分 类 号：R686[医药卫生—骨科学]