桡骨远端骨折42例临床治疗方法及疗效  

Clinical treatment of 42 cases with distal radius fracture

作　　者：赵雁波[1] 张广峰[1] 吴丹丹[1] ZHAO Yanbo;ZHANG Guangfeng;WU Dandan(Department of Orthopaedics,The Air Force Hospital of Central Theater Command of PLA,Datong,Shanxi,037004,China)

机构地区：[1]中国人民解放军中部战区空军医院骨科,山西大同037004

出　　处：《实用手外科杂志》2022年第3期312-314,共3页Journal of Practical Hand Surgery

摘　　要：目的分析桡骨远端骨折各种治疗方法及疗效。方法对2016年1月-2020年1月收治的42例桡骨远端骨折患者,根据骨折类型、程度、年龄及患者意愿,分别行手法复位石膏外固定、闭合或结合有限切开复位克氏针内固定或结合单边外固定架固定、切开复位掌侧钢板内固定治疗。治疗后摄X线片定期复查骨折复位情况,指导功能训练,记录治疗1~2年腕关节功能恢复情况。结果40例获得随访,时间12~24个月。骨折区均愈合好,13例手法复位保守治疗患者中,骨折区高度小部分丢失6例,均有不同程度的掌倾角丢失,手术治疗患者无高度丢失。采用Gartland-Werley评分标准评价腕关节功能,优25例,良10例,差5例。结论手术治疗可积极恢复腕关节功能,能有效避免桡骨远端骨折区高度丢失。特别是对桡骨远端粉碎性骨折、年龄偏大者,即使不愿行切开复位内固定手术治疗,行闭合牵引手法整复后外固定架固定手术治疗,也可一定程度避免保守治疗所致高度丢失发生,影响腕关节功能。Objective To analyze the therapeutic effects of 42 cases with distal radius fracture by diffent methods.Methods Depending on the type,degree,age,and patient preference,manual reduction and plaster external fixation were performed respectively、closed or combined with limited open reduction and kirschner wire internal fixation or combined with unilateral external fixator open reduction and volar plate internal fixation.X-ray was taken after treatment to check the reduction of the fracture,regular review,guidance function exercise,after one to two years of treatment,recovery of wrist function,the wrist function was evaluated by Gartland-Werley score.Results Forty patients were followed up for 12 to 24 months.All the fracture areas healed well,of the 13 patients treated with manual reduction and conservative therapy,the Height of fracture zone was lost in 6 cases,there were different degrees of loss of palm inclination,there was no loss of height in the operative patient.Wrist function recovery,excellent in 25 cases,good 10 in cases,poor in 5 cases.Conclusion Analysis of this group of cases,surgical treatment,can actively restore wrist function,can effectively avoid the distal radius fracture zone height loss.Especially for patients with distal radius bone fracture,even if they do not want to be treated with open reduction and internal fixation,they should be treated with closed traction reduction and external fixation,it can also avoid the loss of height caused by conservative treatment to some extent and affect the function of wrist joint.

关 键 词：桡骨远端骨折 石膏外固定 骨折固定术 内固定 

分 类 号：R687.3[医药卫生—骨科学]