采用外固定支架临时撑开复位掌侧锁定钢板内固定治疗桡骨远端C2、C3型骨折的疗效  

Efficacy of the treatment of external fixation with temporary extension and reduction and volar locking plate for radius distal C2,C3 fractures

作　　者：陈孝均 贺智榆 安贵生[2] 黄强[2] Chen Xiaojun;He Zhiyu;An Guisheng;Huang Qiang(Department of Orthopedics, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646000, China)

机构地区：[1]西南医科大学附属中医医院骨科,泸州646000 [2]北京积水潭医院创伤骨科,100035

出　　处：《骨科临床与研究杂志》2020年第6期330-334,共5页Journal Of Clinical Orthopedics And Research

基　　金：泸州-医科大科研项目(2019LZXNYDJ37)。

摘　　要：目的观察采用跨腕关节外固定支架反向牵引临时撑开复位掌侧锁定钢板内固定治疗桡骨远端C2、C3型骨折的临床疗效。方法2017年3月至2019年2月西南医科大学附属中医医院骨科收治桡骨远端C2、C3型骨折的患者55例,采用跨腕关节外固定支架反向牵引临时撑开复位掌侧锁定钢板内固定进行治疗,其中男31例,女24例;年龄25~79(48.9±11.5)岁。骨折按照AO分型C2型21例,C3型34例。受伤至手术时间2~7 d。末次随访时的X线片检查进行骨折复位效果的评判;患者腕关节功能评级(PRWE)分进行评定。结果全部患者均获得9~36(15.8±5.3)个月的随访。骨折愈合时间为6~18(8.5±1.3)个月。X线片评估患者桡骨高度、掌倾角、尺偏角恢复情况,优29例,良22例,可4例,优良率92.7%。PRWE腕关节功能评优35例,良12例,可6例,差2例,优良率为85.5%。所有病例无正中神经刺激、切口感染、内固定断裂、伸肌腱激惹等并发症。结论采用跨腕关节外固定支架反向牵引临时撑开复位掌侧锁定钢板内固定治疗桡骨远端C2、C3型骨折,骨折复位理想,内固定可靠,腕部功能恢复满意。Objective To observe the clinical efficacy of trans-wrist external fixation with reverse traction and temporary open reduction and volar locking plate fixation for the treatment of radius distal C2 and C3 fractures.Methods From March 2017 to February 2019,55 patients with C2 and C3 fractures of the distal radius were treated with a trans-wrist external fixation by reverse traction and temporary distraction to restore the palmar locking plate.There were 31 males and 24 females,with a mean age of 25-79(48.9±11.5)years.The fractures were followed by AO classification:21 cases of C2 type and 34 cases of C3 type.The time from injury to surgery was 2-7 days.The X-ray examination at the last follow-up was used to judge the effect of fracture reduction;the PRWE(patient wrist assessment)score was used to evaluate the wrist function.Results All patients were followed up for 9-36(15.8±5.3)months.The fracture healing time ranged from 6-18(8.5±1.3)months.X-ray films were used to evaluate the recovery of tibia height,palm tilt angle and ulnar angle.The results were excellent in 29 cases,good in 22 cases,and fair in 4 cases.The excellent and good rate was 92.7%.The PRWE wrist joint function score was excellent in 35 cases,good in 12 cases,fair in 6 cases,and poor in 2 cases,with an excellent and good rate of 85.5%.All cases had no complications such as median nerve stimulation,wound infection,internal fixation fracture,and extensor tendon irritability.Conclusion The use of trans-wrist external fixation by reverse traction and temporary open reduction and volar locking plate internal fixation for the treatment of radius distal C2 and C3 fractures can achieve ideal fracture reduction,reliable internal fixation,satisfactory recovery of wrist function.

关 键 词：桡骨骨折 外固定器 内固定器 锁定钢板 加速康复外科 

分 类 号：R68[医药卫生—骨科学]