保留近排腕骨治疗严重腕关节开放性骨折脱位  

Surgical treatment of severe wrist joint fracture and dislocation without fracture of proximal carpal bones

作　　者：唐辉[1] 沙勇[1] 徐永清[1] 李春晓[1] 张曦娇 浦绍全 丁晶[1] 朱跃良[1] 

机构地区：[1]中国人民解放军成都军区昆明总医院全军骨科研究所,云南昆明650032

出　　处：《实用手外科杂志》2016年第1期13-15,共3页Journal of Practical Hand Surgery

摘　　要：目的 探讨无近排腕骨骨折的严重腕关节开放性骨折脱位的手术治疗方法。方法对2008年1月-2014年1月收治的5例无近排腕骨骨折的严重腕关节开放性骨折脱位患者采用彻底清创、腕关节复位固定、血管神经肌腱探查修复进行治疗。术后对患者腕关节屈伸角度、尺桡偏角度、握力以及神经恢复情况进行随访。结果5例患者均得到随访，时间8～34个月。随访期间腕关节功能良好。腕活动度屈伸75°～115°，平均（95．0±15．0）°。尺桡偏39°～55°，平均（47．4±5．9）°。腕握力为16～21kg，平均（18．8±1．2）kg。结论采用彻底清创、腕关节复位固定、神经血管肌腱I期修复可有效治疗无腕骨骨折的严重腕关节开放性骨折脱位。Objective To investigate surgical treatment of severe wrist joint fracture and dislocation without fracture of proximal carpal bones. Methods 5 patients with severe wrist joint fracture and dislocation without fracture of proximal carpal bones underwent debridement thoroughly, then reduction and fixation of wrist joints was done, vascular nerve and tendon was repaired eventually. All patients were evaluated postoperatively. The function of wrist joint was followed up including the angle of dorsal expansion and palmar flexion, the angle of radial deviation and ulnar deviation, grip and nervous recovery. Results All patients were followed up from 8 to 34 months and get good recovery in function of wrist joint, The angle of dorsal expansion and palmar flexion was 75°～115° and the mean was 95°±15°. The angle of radial deviation and ulnar deviation was 39°～55° and the mean was 47.40°±5.9°, The grip was 16～ 21 kg and the mean was （18.8±1.2） kg. Conclusion Thoroughly debridement, reduction and fixation of wrist joints, repair of vascular nerve and tendon is effective for severe wrist joint fracture and dislocation without fracture of proximal carpal bones.

关 键 词：近排腕骨:腕关节 复位固定 

分 类 号：R683.420.5[医药卫生—骨科学]