桡骨远端粉碎性骨折及关节内骨折的手术治疗  

Open reduction and internal or external fixation for the treatment of comminuted and intra-articular fractures of the distal radius

作　　者：姜保国[1] 张殿英[1] 傅忠国[1] 徐海林[1] 李剑[1] 

机构地区：[1]北京大学人民医院创伤骨科,100044

出　　处：《中华骨科杂志》2002年第2期80-83,共4页Chinese Journal of Orthopaedics

摘　　要：目的探讨桡骨远端粉碎性骨折及关节内骨折的手术治疗方法及临床效果评价。方法对1999年1月～2001年1月通过手术治疗的桡骨远端粉碎性骨折及关节内骨折的42例病例进行分析。按AO原则分类,根据不同的类型分别采用钛板螺钉内固定、简单内固定加外固定架固定及单纯外固定架固定。结果42例患者全部获随访,功能满意35例(83.3%),可6例(14.3%),不满意1例(2.4%)。结论桡骨远端粉碎性骨折及关节内骨折通过手术的方法,能最大限度地恢复桡骨与尺骨的相对长度、关节面的平整、掌倾角及尺偏角,术后配合合理的康复锻炼,能使腕关节功能达到最大的恢复。Objective To evaluate the clinical outcome of surgical treatment of comminuted and intra articular fractures of the distal radius. Methods Forty two cases of comminuted and intra articular fractures of distal radius encountered from January 1999 to January 2001, were operated upon either with internal fixation with the Titanium screw plate or with external fixator according to the types of fracture. Patiens data: there were 14 male and 28 female patients with age of 21-69 years and an average of 36 years; fractures on the left side in 18 and right side in 24 cases. The fractures were categorized according to the AO classification of distal radial fractures: 3 cases of type B1; 8 cases of type B2(dorsal Barton fracture); 4 cases of type B3(volar Barton fracture); 14 cases of type C1; 8 cases of type C2 and 5 cases of type C3. Types B1, B2, B3 and C1 with unsatisfactory closed manipulation were treated primarily with open reduction and internal fixation with an oblique T shaped pure Titanium plate and screws; types C2 and C3 were primarily treated with external fixators; depending upon the condition of reduction during surgery; Kirshners wires were applied accordingly. Twenty six cases were treated with oblique T shaped pure Titanium plate and screws, 9 with open reduction and external fixator, 7 cases were treated with Kirshners wires and external fixator. According to the types of fracture, the pure Titanium plate and screws, simple internal fixation+external fixator, and only external fixator was used accordingly. Results All 42 patients were followed up regularly. According to AO evaluation of the wrist joint movement, 83.3%(35 cases) of the patients had satisfactory functional outcome, 14.3%(6 cases) had quite satisfactory results and only 2.4%(1 case) had unsatisfactory functional outcome. Conclusion The reduction of the distal radial fractures should include the maintenance of the relative length of the radius and ulna, the smoothness of the articular surface and the palmar and ulnar de

关 键 词：桡骨远端粉碎性骨折 内固定器 手术治疗 

分 类 号：R683.41[医药卫生—骨科学]