外支架跨关节固定术对不稳定性桡骨远端骨折的疗效  

Curative Efficacy of External Fixation Across the Joint in Unstable Distal Radius Fracture

作　　者：庞金辉[1] 曹成福[1] 纪斌[1] 周军杰[1] 陈贤奇[1] 王臻[1] 周强[1] 

机构地区：[1]上海中医药大学附属普陀医院骨科,上海200062

出　　处：《南昌大学学报（医学版）》2012年第5期31-33,37,共4页Journal of Nanchang University：Medical Sciences

基　　金：上海市重点建设学科项目(T0303)

摘　　要：目的探讨外固定支架在不稳定性桡骨远端骨折中的治疗效果。方法 62例不稳定性桡骨远端骨折患者(Müller AO分型:A3型14例;C2型28例;C3型20例),均采用手法复位、外固定支架跨关节固定术治疗,必要时辅以克氏针经皮撬拨复位固定。采用改良sarmiento系统评估骨折复位情况、Dienst标准评估腕关节功能并观察术后并发症。结果 62例患者骨折全部愈合,平均愈合时间为5.5周。随访3～12个月,其中53例复位优良,占85.5%;57例腕关节功能优良,占91.9%。有2例出现钉道感染、1例Schanz钉松动,经积极处理后顺利愈合;另有1例出现反射性交感神经性营养不良;未见神经血管损伤、骨折再移位。结论闭合复位外固定支架固定术是治疗不稳定性桡骨远端骨折的有效手段之一。Objective To evaluate the radiological and functional outcome following external fixation of unstable distal radius fractures.Methods Sixty-two patients with unstable distal radius fractures（Müller AO classification：A3 in 14,C2 in 28 and C3 in 20） underwent manipulative reduction and external fixation across the joint.If necessary,additional Kirschner wires were used.Fracture reduction and wrist function were assessed by using improved sarmiento system and Dienst criteria,respectively.Postoperative complications were observed in all patients.Results All fractures healed with an average healing time of 5.5 weeks.After 3 to 12 months of follow-up,excellent fracture reduction was achieved in 53 patients（85.5%） and excellent wrist function in 57 patients（91.9%）.Among the 62 patients,pin tract infection occurred in 2 patients,Schanz screw loosening in 1 patient（fracture healed after active treatment）,and reflex sympathetic dystrophy in 1 patient.No patients had neurovascular injury and fracture re-displacement.Conclusion Combined use of closed reduction and external fixation is an effective method for treating unstable distal radius fractures.

关 键 词：桡骨远端骨折 不稳定性 外固定支架 手法复位 克氏针 

分 类 号：R683.41[医药卫生—骨科学]