外固定架治疗桡骨远端粉碎性骨折  

External Fixation in the Treatment of Comminuted Distal Radius Fractures

作　　者：陈磊[1] 邢伟鹏 李晓东[3] 

机构地区：[1]河南中医学院洛阳研究生工作部,郑州450008 [2]湖南中医药大学第一临床医学院,长沙410208 [3]河南省洛阳正骨医院手外科,洛阳471002

出　　处：《中国中医药现代远程教育》2016年第6期82-83,共2页Chinese Medicine Modern Distance Education of China

摘　　要：目的探讨应用平乐正骨手法复位结合外固定架固定治疗桡骨远端不稳定型骨折的临床效果及体会。方法对就诊于我院的21例桡骨远端骨折的患者,通过手法复位后连接外固定架固定治疗,出院后随访观察骨折愈合、腕关节功能等情况。结果 21例患者均获得随访,随访时间12个月;定期复查X线片,显示骨折均已达到骨性愈合;外固定支架拆除时间为6~9周,平均6.8周;Dienst疗效评定结果,结果优18例,良2例,可1例。优良率95.2%。其中1例开放性骨折病人术后2周发生腕部掌侧皮肤坏死,给予全厚皮植皮修复,愈合良好;1例患者出现钉道感染,以罗红霉素软膏涂抹伤口控制感染;术后X线测量：掌倾角8°~17°（平均11.3°）,尺偏角14°~26°（平均21.2°）,桡骨轴向缩短均得以矫正。结论运用平乐手法复位结合外固定架固定治疗桡骨远端不稳定型骨折操作简单、减轻了手术创伤、降低感染风险、骨折愈合率高、术后腕部功能恢复较好,值得临床推广应用。Objective To investigate the clinical effect and experience of Pingle bonesetting manual reduction combined with external fixation in the treatment of distal radius unstable fractures. Methods21 cases of distal radius fracture patients in our hospital were treated by means of manual reduction and external fixation. After discharge, the fracture healing and wrist function and so on were followed-up. Results 21 patients were followed up for 12 months. Periodic review of X-ray showed bone union. The external fixator removal time was 6 to 9 weeks, an average of 6.8 weeks. The results of Dienst treatment were excellent in 18 cases, good in 2 cases,and in 1 case. Excellent rate was 95.2%, where one case of open fracture patients after 2 weeks occurred wrist volar skin necrosis,giving full thickness skin graft repair and healing well. 1 case had pin tract infection, smearing the wound with roxithromycin ointment to control infection. Postoperation surgery X-ray measurements： palmar angle 8 ° ~ 17 °（average 11.3 °）, ulnar deviation14 ° ~ 26 °（average 21.2 °）, and radial axial shortening all were corrected. Conclusion Pingle manual reduction combined with the use of simple external fixation treatment of unstable distal radius fractures has the advantages of simple operation, reducing the operation trauma, reducing the risk of infection, has high healing rate and good postoperative wrist function recovery. It is worthy of clinical application.

关 键 词：平乐正骨手法 外固定架 桡骨远端不稳定型骨折 中医骨伤科 

分 类 号：R687.3[医药卫生—骨科学]