桡骨远端粉碎性骨折累及关节面手术治疗体会  

Experiences on surgical treatment of comminuted fractures of distal radius involving articular surface

作　　者：张茗慧[1] 李岳伟[1] 李小荣[1] 

机构地区：[1]解放军第174医院骨三科,福建厦门361003

出　　处：《实用临床医药杂志》2013年第17期163-165,共3页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11321104)

摘　　要：目的 探讨桡骨远端粉碎性骨折累及关节面手术的治疗方法及疗效.方法 采用切开复位“T”型纯钛金属板螺钉内固定、切开复位外固定架固定及切开复位克氏针固定加外固定架固定等手术方法治疗桡骨远端粉碎性骨折累及关节面手术患者.观察患者预后骨折愈合情况,测量掌倾角和尺偏角.对骨折复位后的功能进行评价.评价患者预后功能恢复情况,调查患者术后满意度.结果 30例患者骨折全部愈合,关节面平整.骨折复位后功能优良率为86.67％.9例患侧腕关节伸屈活动达到健侧活动度；11例背伸近于健侧活动度,但掌屈达到健侧60％ ～78％；9例背伸及掌屈均仅达健侧60％ ～～78％；1例活动度在健侧的60％以下.30例患者中,27例患者屈伸活动无疼痛,3例有轻微疼痛.所有患者均无内旋障碍.对术后腕关节功能表示满意者占83.33％.结论 经合理的手术方法治疗桡骨远端粉碎性骨折累及关节内骨折,能最大限度地恢复桡尺骨的相对长度、关节面平整.Objective To discuss the surgical treatment and its effect on comminuted frac- tures of distant radius involving articular surface. Methods Internal fixation with type T pure tita- nium plate screw, external fixator or closed reduction combined with external fixator after open re- duction were applied to treat patients with comminuted fractures of distant radius involving articular surface. Prognostic fracture healing condition, bone function after reduction and its functional re- covery as well as postoperative satisfaction were evaluated while palmar and ulna tilts were mea- sured. Results Thirty cases were all recovered from bone fractures with smooth articular surface and 86.67 % functional recovery rate was observed after reduction. Nine cases were with normal ac- tivity on damaged joint extension - flexion, 11 on dorsal stretch with 60 % - 78 % of palmar flexion, 9 cases had 60 % - 78 % dorsal stretch and palmar flexion of healthy limbs, while only one was be- low 60 % of the normal activity. Of 30 cases, 27 had no pain and 3 had slight pain in extension- flexion activity. All cases had no difficulty in internal rotation with an 83.33 % postoperative satis- faction rate. Conclusion Reasonable surgical treatment of comminuted fractures of distant radius involving articular surface can furthest recover the relevant length of ulna and the smoothness of ar- ticular surface.

关 键 词：桡骨 粉碎性骨折 关节面 手术 

分 类 号：R683.4[医药卫生—骨科学]