动力型外固定架结合克氏针有限内固定治疗桡骨远端不稳定性骨折临床疗效  

Clinical outcomes on effects of dynamic external fixator combined with Kirschner wire and antiosteoporosis for treatment of unstable distal radius fractures

作　　者：段强民[1] 王宝鹏[1] 刘亮[1] 吕云亮[1] 李福东[1] 常西海[1] 

机构地区：[1]滨州医学院附属淄博市临淄区人民医院骨科,山东淄博255400

出　　处：《中国矫形外科杂志》2012年第10期877-879,共3页Orthopedic Journal of China

摘　　要：[目的]探讨动力型外固定架加克氏针有限内固定联合抗骨质疏松治疗桡骨远端骨折(A3、C2、C3)的临床疗效。[方法]2004年8月～2010年8月采用动力型外固定架加克氏针有限内固定治疗桡骨远端不稳定性骨折72例。6～8周拆除外固定架。72例患者随机分为治疗组(36例)和对照组(36例);治疗组给予抗骨质疏松药物治疗,对照组仅给予安慰剂治疗。[结果]所有患者均获得14～24个月随访,平均18个月;所有患者11周均达骨性愈合,骨折愈合时间:治疗组5～8周(平均6.5周),对照组6～11周(平均8.5周)。依Dienest评分标准:治疗组,优18例,良15例,差3例,优良率为91.7%;对照组,优12例,良18例,差6例,优良率为83.3%。[结论]动力型外固定架加克氏针有限内固定治疗桡骨远端不稳定性骨折具有操作简单、复位满意、固定坚强等优点;联合抗骨质疏松治疗,能改善骨结构、增加骨折稳定性、减少固定时间,可明显改善患者疼痛程度,配合早期合理的腕关节功能锻炼,腕关节功能恢复良好,疗效满意。[Objective]To evaluate the clinical outcomes of dynamie external fixator combined with Kirschner wire and antiosteoporosis for treatment of unstable distal radius fractures（A3、C2、C3）.[Method]From August 2004 to August 2010,72 consecutive patients with unstable distal radius fractures were treated with dynamie external fixator combined with Kirschner wire.Exercises of the wrist was done after removal of dynamie external fixator in 6-8 weeks postoperatively.Seventy-two consecutive patients were detected and divided into two groups.Patients in treated group（36 cases）were treated by antiosteoporosis,while those in control group（36 cases）were treated by placebo.[Result]The patients were followed up for an average of 18 months（range,14-24 months）.All fractures united in 11weeks postoperatively.The fracture healing time in the treated group was an average of 6.5 weeks（range,5-8 weeks） and that in the control group was 8.5 weeks（range,6-11 weeks）.The Dienest scoring systerm showed that 18 cases were excellent,15 good and 3 poor in the treated group（the good to excellect results rate was 91.7%）.By contrast,12 cases were excellent,18 good and 6 poor in control group（the good to excellect results rate was 83.3%）.[Conclusion]Treatment of unstable distal radius fractures with dynamie external fixator combined with Kirschner wire offers many advantages,such as simple operation,satisfactory reduction and rigid fixation.Antiosteoporosis can improve the bone structure and increase the instability of fracture,reduce the extemal fixation in treated group.Additionally,reasonable early exercises of the wrist is reliable and effective in treatment of unstable distal radius fractures.

关 键 词：桡骨远端骨折 不稳定性 外固定架 克氏针 骨质疏松 

分 类 号：R687.3[医药卫生—骨科学]