桡骨远端粉碎性骨折的微创穿针外固定治疗  

Minimally Invasive Needle Fixation for Comminuted Fractures of Distal Radius

作　　者：魏国文 谭小云[2] 曹婕 王成智 王宏 

机构地区：[1]南昌市第一人民医院骨科,南昌330008 [2]中国人民解放军第413医院骨科,浙江舟山316000

出　　处：《实用临床医学（江西）》2012年第11期30-32,共3页Practical Clinical Medicine

基　　金：江西省卫生厅科技计划项目(20122041)

摘　　要：目的探讨闭合复位外固定或有限切开复位外固定治疗桡骨远端粉碎性骨折的疗效。方法对89例桡骨远端粉碎性骨折患者采用闭合复位外固定或有限切开复位外固定治疗,结合微创穿针外固定架固定骨折。结果 89例患者随访86例,失访3例,随访率为96.6%。随访时间5～48个月,平均26个月。骨折全部1期愈合。按照Dienst功能评分标准:优75例,良8例,一般3例,优良率为96.5%。X线片评估:桡骨短缩<10 mm,关节塌陷<2 mm,尺偏角12°～15°,掌倾角6°～15°。无针孔骨折,医源性神经、血管损伤,针道感染及骨髓炎等并发症发生。结论应用外固定支架固定是治疗桡骨远端粉碎性骨折的有效方法,能较好地防止骨折再移位、畸形愈合和保护腕关节功能。Objective To investigate curative efficacy of the closed reduction or limited open reduction combined with external fixation in comminuted fractures of distal radius.Methods A total of 89 patients with comminuted fractures of distal radius were treated with the closed reduction or limited open reduction combined with minimally invasive needle fixation.Results Among the 89 patients,86（96.6%） were followed-up for an average of 26 months（range 5 to 48 months）.All fractures achieved primary healing of incisions.According to Dienst function score system,results were excellent in 75 patients,good in 8 and fair in 3.The excellent and good rate was 96.5%.X-ray assessment showed radial shortening 10 mm,joint collapse 2 mm,ulnar deviation 12°-15°,and palmar angle 6°-15°.No pinhole fractures,iatrogenic nerve,vascular injury,pin tract infection,osteomyelitis and other complications occurred in patients.Conclusion The external fixation is effective for comminuted fractures of distal radius,and can prevent fracture re-displacement and malunion and protect the wrist function.

关 键 词：桡骨远端骨折 粉碎性骨折 外固定架固定 Dienst功能评估 微创 

分 类 号：R683.41[医药卫生—骨科学]