外固定支架结合克氏针治疗老年桡骨远端开放性骨折的疗效分析  

Clinical efficacy analysis of external fixators with Kirschner wires for treatment of open distal radius fracture in elderly patients

作　　者：柴雷子[1] 宋财[1] 刘杰[1] 田浩然[1] 张伟[1] Chai Leizi;Song Cai;Liu Jie;Tian Haoran;Zhang Wei(Department of Orthopaedics,Bozhou People's Hospital,Bozhou 236800,China)

机构地区：[1]亳州市人民医院创伤骨科,236800

出　　处：《中华肩肘外科电子杂志》2020年第3期243-247,共5页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：国家卫生计生委医药卫生科技发展研究中心(W2015QJ058)。

摘　　要：目的探讨外固定支架结合克氏针治疗老年桡骨远端开放性骨折的临床疗效。方法回顾性分析2018年2月至2019年8月期间亳州市人民医院使用外固定支架结合克氏针治疗的13例老年桡骨远端开放性骨折患者资料,其中男8例、女5例;年龄为62~84岁,平均68.3岁;左侧9例,右侧4例。按Gustilo分型:Ⅱ型7例,ⅢA型5例,ⅢB型1例。结果 13例患者术后获得6~15个月(平均10个月)随访。所有患者均获得愈合,愈合时间6~12周,平均10.8周。主要并发症:复位丢失3例(23.1%),经及时调整外固定支架后改善;关节僵硬4例(30.1%),经康复理疗后症状好转;创伤性关节炎2例(15.4%),经康复科理疗及药物治疗后症状好转;针道感染2例(15.4%),经换药后感染控制。末次随访时参考Gartland-Werley评分标准评价腕关节功能恢复情况:优5例,良6例,一般2例,差0例,优良率84.6%。结论外固定支架结合克氏针治疗老年桡骨远端开放性骨折疗效满意,值得临床推广。Background Distal radial fracture is one of the common clinical fractures,which often occur in elderly patients and are mainly closed fractures.However,open distal radial fracture is relatively rare.In recent years,traffic injuries are raising with the development of social economy in China,and as the power-assisted electric vehicle is popularized among the elderly in this region,the population of elderly open distal radial fractures grows.External fixators have been widely adopted for treatment of closed distal radial fractures in clinical practice,and achieved satisfactory clinical efficacy.The reports of external fixators in the treatment of open distal radial fractures are rare.Objective To explore the clinical efficacy of external fixators with Kirschner wires for treatment of open distal radial fracture in elderly patients.Methods From February 2018 to August 2019,13 elderly patients with open distal radial fractures were treated with external fixators combined with Kirschner wires.The were 8 males and 5 females,and their ages ranged from 62 to 84 years(meanly 68.3 years).There were 9 cases on the left side and 4 cases on the right side.According to Gustilo classification,there were 7 cases of typeⅡ,5 cases of typeⅢA and 1 case of typeⅢB.Results All the patients were followed up for 6 to 15 months(meanly 10 months).All fractures healed after an average time of 10.8 weeks(from 6 to 12 weeks).The main complications were as follows:3 cases(23.1%)had reduction loss,and improved after timely adjustment of their external fixators;4 cases(30.1%)developed joint stiffness,and recovered after physical therapy;2(15.4%)cases had traumatic wrist arthritis,which improved after physical and drug therapy;2(15.4%)cases had pin site infection,and recovered after regular wound dressing.The wrist function restoration was assessed according to GartlandWerley criteria.In the last follow-up,there were 5 excellent cases,6 good cases,2 moderate cases and no poor case,and the excellent and good rate was 84.6%.Conclusions Exter

关 键 词：桡骨远端骨折 开放性 外固定支架 克氏针 

分 类 号：R687.3[医药卫生—骨科学]