骨移植术修复桡骨远端关节面的临床应用研究  

Research on clinical application of bone transplantation on repairing articular facet of distal radius

作　　者：林勇[1] 曾秋涛[1] 林雪萍[1] 阮张涛 

机构地区：[1]南方医科大学附属顺德第一人民医院,广东528300

出　　处：《齐齐哈尔医学院学报》2015年第10期1451-1453,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨取髂骨植骨术重建、修复桡骨远端关节面的疗效结果。方法 2012年6月至2014年9月,应用外固定支架＋手术切开复位内固定术＋取髂骨植骨术治疗桡骨远端严重关节内粉碎骨折合并关节面缺损15例。结果术后14例X线片显示：关节面分离和错位〈1.0 mm 10例,〈2.0 mm 4例,掌倾角为0~15°,尺倾角20~30°,14例无骨短缩,骨折均全部愈合,临床愈合时间为10~16周。1例合并颅脑损伤患者因术后欠合作,强行活动腕关节及撞击外固定支架,造成支架松动,骨折复位丢失及骨折延迟愈合,虽经补救手术治疗,患者腕关节功能恢复欠佳。15例获得4~18个月随访,所有病例采用Gartland-Werley功能评分标准评估腕关节功能,优秀（0~2分）4例,良好（3~8分）7例,一般（9~14分）3例,差（≥15分）1例。结论该术式可以重建桡骨远端干骺端,可以解决桡骨远端关节面因骨质缺损带来的关节失稳的问题,并能挽救腕关节的部分运动功能,减少早期行桡腕关节融合术的几率,减少或减轻创伤性关节炎的发生。Objective To investigate the therapeutic effect of the iliac bone graft to reconstruct and repair the articular surface of the distal radius. Methods During June,2012 to Sept. 2014,application of external fixator and operation of open reduction an interal fixation and ilia bone grafting on the treament of distal radius comminuted intraarticular fractures with articular surface defect in 15 cases. Results After operation,14 cases of X-ray flim showed the articular surface separation and dislocation 2. 0mm in 4 cases, 1. 0mm in 10 cases,palmar tilt to 0 to 15 degrees,ulna inclination 20 to 30 degrees,14 cases without shortening of bone,fracture healing, healing time was 10 to 16 weeks. In 1 patients with craniocerebral injury patients for postoperative owe cooperation,forced wrist external fixator and impact,causing bracket loosening,loss of reduction and fracture healing fracture,although after the remedial operation treament,wrist jiont funtion recovery in patients with poor. All 15 cases were followed up for 4 to 18 months,all patients with Gartland-Werley funtioal score standard evaluation funtion of wrist jiont,excellent（ 0 ~ 2 score） in 4 cases,Good（ 3 ~ 8 score） in 7cases,（ 9 ~ 14 score） in 3cases,（ more than 15score） in 1 case. Conclusions This technique can reconstruct the radius distal metaphysis,can solve joint surface of the distal radius bone defect caused by instability of some movement,and can save the wrist joint,reduce early chances for radiocarpal fusion,reduce or mitigate the occurrence of traumatic arthritis.

关 键 词：骨移植术 桡骨远端骨折 关节面缺损 

分 类 号：R681.7[医药卫生—骨科学]