关节镜辅助下静态牵引综合治疗桡骨远端关节内骨折的临床疗效观察  

Clinical observation of static traction combined with arthroscopy in the treatment of intra-articular fractures of distal radius

作　　者：刘安 盛伟 Liu An;Sheng Wei(Department of Orthopedics,Huangshi Love and Health Hospital Affiliated of Hubei Polytechnic University,Huangshi Hubei,435000,China)

机构地区：[1]湖北理工学院附属黄石爱康医院骨科,湖北黄石435000

出　　处：《生物骨科材料与临床研究》2023年第3期27-31,共5页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的观察关节镜辅助下静态牵引综合治疗桡骨远端关节内骨折的临床疗效。方法回顾性分析湖北理工学院附属黄石爱康医院骨科2017年9月至2021年1月收治的23例采用关节镜辅助治疗的桡骨远端完全关节内骨折患者的临床资料。其中,男12例,女11例;年龄40~69岁,平均53.83岁。采用外固定架扩大腕关节间隙,临时复位固定后,无需使用专用腕关节镜牵引系统,利用关节镜系统进一步探查关节面复位情况及TFCC等相关软组织并视损伤情况进行修复。术后4周根据复查情况拆除外固定架,统计患者术后骨折愈合时间及并发症发生情况,采用VAS评分记录术后10个月疼痛情况,采用Mayo评分和DASH评分评价患者腕关节功能。结果23例患者术后随访10~25个月,平均13.8个月。术后未发现外固定松动、严重钉道感染等并发症。骨折愈合时间5~6周,平均5.3周。Mayo腕关节功能评分85~94分,平均90.7分,优20例,良3例。DASH评分7~13分,平均10.7分。活动伴有疼痛2例,为轻度疼痛(VAS评分2~3分)。结论关节镜辅助下静态牵引综合治疗桡骨远端关节内骨折具有创伤小、恢复快、疗效好、并发症少等优点,值得临床推广应用。Objective To observe the clinical effect of static traction combined with arthroscopy in the treatment of intraarticular fractures of distal radius.Methods The clinical data of 23 patients with intra-articular fracture of distal radius,who were treated by arthroscopy in Huangshi Love and Health Hospital Affiliated of Hubei Polytechnic University from September 2017 to January 2021 were retrospectively analyzed.There were 12 males and 11 females,aged 40-69 years,with a mean age of 53.83 year.An external fixator was used to increase the wrist joint space.After reduction and fixation,an arthroscopic system was inserted to further explore and repair the articular surface and TFCC.The external fixator was removed at 4 weeks after operation according to the review.Postoperative fracture healing time and complications were recorded.VAS score was used to record the pain at 10 months after operation.Mayo score and DASH score were used to evaluate the wrist function of patients at 10 months after operation.Results All 23 patients were followed up for 10-25 months(mean 13.8 months).There were no postoperative complications such as external fixation loosening or serious nailpath infection.Fracture healing time was 5-6 weeks(mean 5.3 weeks).The Mayo wrist function score was 85-94(mean 90.7),excellent in 20 cases and good in 3 cases.The DASH score ranged from 7 to 13,with an average of 10.7.There were 2 cases of mild pain associated with activity(VAS score 2-3).Conclusion Arthroscopy-assisted static traction in the treatment of intra-articular fractures of distal radius has the advantages of small trauma,quick recovery,good curative effect,few complications,which is worthy of clinical application.

关 键 词：桡骨远端关节内骨折 外固定 下尺桡关节 腕关节镜 静态牵引 

分 类 号：R683.41[医药卫生—骨科学]