闭合复位经皮穿针三角构型内固定治疗C型桡骨远端骨折55例  

55 Cases Clinical Study on Closed Reduction and Percutaneous Pinning with Kirschner Wire in Treating Triangular Configuration for Type C Fractures of the Distal Radius

作　　者：李琰 孙晋客 张峻玮 王辉亮 乔永平 姜红江 孙鹏 丁英状 LI Yan;SUN Jinke;ZHANG Junwei;WANG Huiliang;QIAO Yongping;JIANG Hongjiang;SUN Peng;DING Yingzhuang(Shandong Wendeng Orthopedic Hospital,Weihai 264400,Shandong China;ShandongAcademy of Traditional ChineseMI edicine Orthopedics and Traumatology,Weihai 264400,Shandong China.)

机构地区：[1]山东省文登整骨医院,山东威海264400 [2]山东省中医骨伤研究院

出　　处：《中国中医骨伤科杂志》2022年第11期49-53,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：基本中医药循证能力建设项目(国中医药科技中医便函[2019]130号);全国名老中医药专家孙文学传承工作室建设项目(国中医药人教函[2018]134号);威海市第三批中医重点专科(四肢创伤科)项目(威卫计中医[2017]14号);威海市中医药科技面上项目(2021N-02)。

摘　　要：目的:评估闭合复位经皮穿刺克氏针三角构型内固定治疗C型桡骨远端骨折的临床疗效。方法:回顾性分析2020年10月至2021年12月接受手术的55例C型桡骨远端骨折患者。男14例,女41例;年龄为34~81岁,平均为(59.96±9.10)岁。根据术前X线和CT影像学资料明确骨折损伤情况,均给予闭合复位经皮穿刺克氏针三角构型内固定治疗。随访观察3个月,测量桡骨高度、尺偏角、掌倾角,记录骨折愈合时间、并发症,采用腕关节患者自行评估量表(PRWE)评价腕关节功能,评估疗效。结果:所有患者均顺利完成手术,手术时间为20~45 min,平均为(32.00±6.64)min,末次随访时所有患者骨折全部愈合。PRWE评估疗效:优20例,良27例,可4例,差4例,满意率为92.73%;术后第1天,所有患者桡骨高度、尺偏角、掌倾角均获得明显恢复((5.78±1.92)mm比(12.91±1.73)mm,t=27.458,P<0.001;11.71°±2.80°比21.00°±1.78°,t=20.478,P<0.001;-14.18°±4.15°比11.65°±2.19°,t=40.352,P<0.001);末次随访时,所有患者桡骨高度、尺偏角、掌倾角维持良好((12.91±1.73)mm比(12.78±1.65)mm,Z=-1.698,P=0.090;21.00°±1.78°比20.89°±1.75°,Z=-1.897,P=0.058;11.65°±2.19°比11.55°±2.04°,Z=-1.500,P=0.134);随访期间5例患者出现并发症,3例为针道感染,2例为肌腱刺激,并发症发生率为9.10%。结论:闭合复位经皮穿刺克氏针三角构型治疗C型桡骨远端骨折可获得良好复位及治疗效果,远期疗效仍需进一步随访观察。Objective:To evaluate the clinical efficacy of closed reduction and percutaneous pinning with Kirschner wire in treating triangular configuration for type C fractures of the distal radius.Methods:55 patients with type C distal radius fractures operated from October 2020 to December 2021 were analyzed retrospectively,including 14 males and 41 females,aged from 34 to 81 years old,with(59.96±9.10)years old on average.Fraction situation were determined according to preoperative X ray and CT data.All patients were treated with closed reduction and percutaneous with Kirschner wire in triangular configuration.All were followed up for 3 months.The radial height,ulnar declination,palm dip angle and patient-rated wrist evaluation(PRWE)wrist function scores were used to evaluate the clinical efficacy.The fracture healing time and complications were recorded.Results:All 55 patients were successfully completed closed reduction and internal fixation.The operation time was 20 to 45 min,with(32.00±6.64)min on average.All patients got clinical healing at the last follow-up.PRWE wrist score scale results showed that 20 cases were excellent,27 cases were good,4 cases were fair,4 cases were poor,excellent and good results come to 85.45%.Compared before operation,the radial height,ulnar declination and palmar inclination of all patients recovered significantly((5.78±1.92)mm vs(12.91±1.73)mm,t=27.458,P<0.001;11.71°±2.80°vs 21.00°±1.78°,t=20.478,P<0.001;-14.18°±4.15°vs 11.65°±2.19°,t=40.352,P<0.001)on the 1 st day after the operation.No significant loss of fracture reduction was found in all patients 3 months after operation((12.91±1.73)mm vs(12.78±1.65)mm,Z=-1.698,P=0.090;21.00°±1.78°vs 20.89°±1.75°,Z=-1.897,P=0.058;11.65°±2.19°vs 11.55°±2.04°,Z=-1.500,P=0.134);Postoperative complications occurred in 5 cases during the follow-up,3 cases with needle tract infection and 2 cases with tendon irritation,and the complication rate was 9.10%.Conclusion:Closed reduction and percutaneous pinning with Kirschner wire

关 键 词：C型桡骨骨折 骨折闭合复位 克氏针 骨折内固定 

分 类 号：R683.41[医药卫生—骨科学]