腕关节镜辅助下切开复位经骨窗植骨内固定治疗桡骨远端Die-punch骨折  

Wrist arthroscopy assisted open reduction and bone graft through bone window internal fixation for the treatment of distal radius Die-punch fractures

作　　者：程亚博[1] 杨顺[1] CHENG Ya-bo;YANG Shun(Department of Wrist,Sichuan Provincial Orthopaedics Hospital,Chengdu,610041,Sichuan,China)

机构地区：[1]四川省骨科医院手腕科

出　　处：《中国骨伤》2019年第8期731-735,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨腕关节镜辅助下切开掌侧经骨窗撬拨复位植骨内固定治疗桡骨远端(Die-punch)骨折的临床疗效。方法:自2016年3月至2017年3月,采用腕关节镜辅助下切开复位经骨窗植骨内固定治疗桡骨远端Die-punch骨折患者12例,男8例,女4例;年龄20~42岁。术前X线片及CT明确诊断为桡骨远端Die-punch骨折。观察患者关节活动度情况,术后12个月采用VAS评分评价疼痛缓解程度,采用Cooney腕关节评分对患者腕关节功能恢复情况进行评估。结果:全部患者无手术并发症,12例患者术后均获随访,时间10~13个月。术后12个月VAS评分0~3分。腕关节掌倾角5°~15°,尺偏角14°~23°,屈伸活动度123°~168°,前臂旋转活动度115°~170°。术后12个月Cooney腕关节评分70~95分;优10例,良1例,可1例。结论:腕关节镜辅助下切开掌侧经骨窗撬拨复位植骨内固定治疗桡骨远端Die-punch骨折,术后手腕部功能恢复良好,疼痛症状较轻,临床效果满意。Objective:To explore clinical effect of wrist arthroscopy assisted open reduction and bone graft through bone window internal fixation in treating distal radius Die-punch fractures.Methods:From March 2016 to March 2017,12 patients with distal radius Die-punch fractures were treated by wrist arthroscopy assisted open reduction and bone graft through bone window internal fixation,including 8 males and 4 females aged from 20 to 42 years old.Preopeative X-ray and CT were used to diagnosed as compress and collapse Die-punch fractures.Joint activity was observed,postoperative VAS score and Cooney wrist score were used to evaluate pain and wrist function at 12 months.Results:No surgical complications occurred.All patients were followed up from 10 to 13 months with an average of 12.1 months.VAS score was for 0 to 3 points at 12 months after operation.Palmer tilt angle was for 5°to 15°,ulnar drift angle was for 14°to 23°,wrist flexion motion ranged from 123°to 168°,and forearm rotation motion ranged from 115°to 170°.Postoperative Cooney wrist score at 12 months ranged from 70 to 95 points,10 patients got excellent results,1 good,and 1 moderate.Conclusion:Wrist arthroscopy assisted open reduction and bone graft through bone window internal fixation in treating distal radius Die-punch fractures has advantages of good recovery of wrist function,reduce pain symptom,and could receive satisfied clinical effects.

关 键 词：关节镜 桡骨骨折 骨折切开复位 

分 类 号：R683.41[医药卫生—骨科学]