桡骨远端骨质疏松骨折外固定架固定术的临床观察  

Treatment of osteoporotic fractures in the distal radius with external fixation for elderly patients

作　　者：刘利民[1] 沈惠良[1] 王玮[1] 武京伟[1] 彭建光[1] 

机构地区：[1]首都医科大学宣武医院骨科,北京100053

出　　处：《北京医学》2014年第5期373-375,共3页Beijing Medical Journal

摘　　要：目的探讨桡骨远端骨质疏松骨折外固定架固定术的可行性。方法2009年5月至2012年6月共收治桡骨远端骨质疏松骨折患者177例．26例（14．7％）行外固定架固定术，其中15例切开复位，11例闭合复位外固定术。AO分型：B型4例，C型22例。结果25例获3～20个月随访，随访率为96．2％。Garland—Wedey功能评分：优8例，良11例，可4例，差2例（8％），总优良率为76％。切开复位14例中，优5例，良6例（优良率78．6％），可3例；闭合复位11例中，优3例，良5例（优良率72．7％），可1例，差2例（18．2％）。结论具有微创特点的外固定术符合年老体弱患者的手术要求：有限切开复位，有助于恢复桡骨远端长度和关节面的解剖关系。外固定架固定术具有较好的骨性固定．有助于稳定骨折端．是桡骨远端骨质疏松骨折的有效治疗方法。Objective To explore the feasibility of external fixation of osteoporotic fractures in distal radius for el- der patients. Methods One hundred and seventy-seven cases of distal radial fractures with osteoporosis from May, 2009 to Jun, 2012 were treated. Among them, 26 cases （14.7%, with 4 cases of type B and 22 cases of type C in AO classification） were treated with external fixation after either open （15 cases） or close （11 cases） reductions. Results Twenty-five out of the 26 cases （96.2%） were followed up for 3-20 months and evaluated with Gartland and Werley evaluation systems. Eight patients were fulfilled the criteria of excellence, 11 were good （the total satisfaction rate was 76%）, 4 were fair and 2 were poor （8%）. Of the 14 cases with open reduction who were followed up, 5 were excellent, 6 were good （78.6%）, 3 were fair and there was no case of poor. Of the 11 cases with close reduction cases, 3 were excellent,5 were good （72.7%）, 1 was fair and 2 were poor （18.2%）. Conclusion External fixation is suitable for surgical procedures in elderly patients because of its minimally invasive in nature and limited open reduction can facilitate the rehabilitation of the anatomical relations such as the radial length and articular surface of the distal radius, and good bone stability without displacement of the distal radius. Therefore, it is an effective approach in the treatment of osteoporotic fractures in the distal radius in elder patients.

关 键 词：桡骨远端 骨质疏松骨折 外固定架 固定术 

分 类 号：R687.3[医药卫生—骨科学]