动力型外固定支架结合微创复位植骨与锁定钢板内固定治疗桡骨远端骨折的比较研究  

The treatment of AO type C fractures of the distal radius with dynamic external fixation combined with minimally invasive reset and bone gratting and locking compression plate

作　　者：付炳金[1] 朱晓东[1] 

机构地区：[1]滨州医学院附属医院骨科,滨州256603

出　　处：《滨州医学院学报》2014年第2期90-93,101,共5页Journal of Binzhou Medical University

摘　　要：目的：总结动力型外固定支架结合微创复位＋植骨与锁定加压钢板内固定治疗桡骨远端AO分型C2型与C3型骨折的疗效，探讨2种治疗方案的优缺点。方法对2010年9月～2014年3月62例桡骨远端AO分型C2型与C3型骨折的临床资料进行回顾与分析，其中32例采用动力型外固定支架结合微创复位＋植骨治疗，30例采用锁定加压钢板内固定治疗。随访时间为24个月。统计患者X线片计量资料，手术后常见并发症，以及腕关节Gartland-Werley功能评分，进行统计学分析。结果手术后常见并发症：外固定支架组4例，锁定加压钢板组4例。手术后24个月Gartland-Werley功能评分：外固定支架组优/良28例，可/差4例；锁定加压钢板组优/良28例，可/差2例。各项指标对比结果，外固定支架组与锁定加压钢板组无明显统计学差异（ P＞0．05）。结论动力型外固定支架结合微创复位＋植骨治疗桡骨远端C2型与C3型骨折，不仅操作简便，创伤小，有效保护了骨折周围软组织及骨折周围血液供应，还通过直视下复位，有效纠正桡骨远端短缩畸形与成角畸形，使骨折断端达到解剖复位，并牢固固定；锁定加压钢板治疗桡骨远端C2型与C3型骨折，也通过直视下复位，有效纠正了桡骨远端畸形与桡骨远端关节面台阶，增加了复位的满意程度，锁定加压钢板锁定系统的固定强度高，能有效避免骨折复位丢失，并允许腕关节早期功能锻炼；动力型外固定支架结合微创复位＋植骨与锁定加压钢板治疗桡骨远端AO分型C2型与C3型骨折，X线片计量资料评分满意，腕关节功能评分满意，手术并发症少，临床应用时，可以根据具体情况，灵活选择。Objective To summarize the treatment effect of AO type C2 and C3 fractures of the distal radius with dynamic ex-ternal fixation combined with minimally invasive reset and bone grafting and open reduction combined with locking compression plate internal fixation .To evaluate the merit and demerit of the two methods .Methods From September 2010 to March 2014 , we choose 62 cases with AO type C2 and C3 fractures of the distal radius ,and make a retrospective study of these patients＇fol-low -up data .32 cases were treated with dynamic external fixation combined with minimally invasive reset and bone grafting , 30 cases were treated with open reduction combined with locking compression plate internal fixation .Collected and sorted out the patients＇X-ray measurement data ,the common surgery complications ,as well as the wrists＇Gartland-Werley function scores ,for statistical analysis .Results 62 cases of distal radius fractures have received bone healing .After surgeries ,the com-mon surgery complications showed that ,in the external fixation group ,nail track infection 2 ,wrist joint pain 1 ,wrist joint stiffness 1;whilein the LCP group ,wound infection 2 ,wrist joint pain 2 .At 24 months after the treatments ,the wrists＇Gart-land-Werley function scores showed that ,in the external fixation group ,excellent /good 28;whilein the LCP group ,excel-lent /good 28 .After statistical analysis ,The external fixation group and the LCP group was pointless to cast （P〉0.05） .Con-clusions The treatment of AO type C2 and C3 fractures of the distal radius with dynamic external fixation combined with mini-mally invasive reset and bone grafting is an effective method .This method is simple ,less invasive .It can effectively correct the shortening deformity and angular deformity of the distal radius ,making an anatomical reduction of the distal radius fractures , and increasing the stability of the fractures .The treatment of AO type C2 and C3 fractures of the distal radius with locking com-pression plate is an effective

关 键 词：动力型外固定支架 微创复位 植骨 锁定加压钢板 桡骨远端AO分型C型骨折 

分 类 号：R687.3[医药卫生—骨科学]