改良Uhl闭合穿针技术治疗Colles骨折回顾性研究  

Retrospective study on the modified Uhl technique of closed reduction and percutaneous pin in the treatment of Colles'fracture

作　　者：李朝辉 孙忠义 聂真 陈煜[2] 聂伟志 LI Zhao-hui;SUN Zhong-yi;NIE Zhen;CHEN Yu;NIE Wei-zhi(Department of Trauma Rehabilitation,Wendeng Osteopathic Hospital of Shandong,Weihai264400,Shandong,China;Beijing Institute of Technology,Beijing 100081,China)

机构地区：[1]山东省文登整骨医院创伤整复科,山东威海264400 [2]北京理工大学,北京100081

出　　处：《中国骨伤》2023年第9期821-826,共6页China Journal of Orthopaedics and Traumatology

摘　　要：目的:回顾性分析中国接骨学(Chinese osteosynthesis,CO)理念指导下改良Uhl技术治疗Colles骨折的优势。方法:回顾性研究2016年1月至2021年6月采用改良Uhl闭合穿针技术治疗Colles骨折358例,符合条件的纳入120例,按照手术方法不同分为两组:闭合穿针组和切开复位组。闭合穿针组68例,采用CO接骨理念指导下改良Uhl闭合复位经皮穿针技术;切开复位组52例,采用切开复位钢板内固定技术。术后6个月比较两组腕关节改良的Sarmiento影像学评分、Gartland-Werley腕关节评分及手术时间、住院时间、治疗费用。结果:两组患者均获得6个月以上随访。两组在Sarmiento影像学评分、Gartland-Werley腕关节评分方面比较,差异无统计学意义(P>0.05)。闭合穿针组手术时间(35.88±14.11)min、住院时间(9.78±2.48)d、治疗费用(16074.91±1964.48)元,与切开复位组手术时间(65.48±14.26)min、住院时间(15.88±2.00)d、治疗费用(20451.27±1760.22)元相比,差异有统计学意义(P<0.05),闭合穿针组优于切开复位组。结论:与切开复位钢板内固定相比,改良Uhl闭合复位经皮穿针技术治疗Colles骨折具有固定可靠、创伤小、手术快、痛苦小、住院时间短、治疗费用低等优点,是一种值得推广的优势技术。缺点是钢针滑移易损伤肌腱,针对合并粉碎骨块且有骨质疏松的Colles骨折,可能无法牢固固定,需结合其他技术。Objective To retrospectively assess the advantages of the modified Uhl technique in the treatment of Colles'fracture guided by the principles of Chinese osteosynthesis(CO)concept.Methods A retrospective study was conducted on 358 patients with Colles'fracture treated with the modified Uhl technique of closed reduction and percutaneous pin between January 2016 and June 2021.Out of these,120 eligible cases were selected and categorized into two groups according to different surgical methods:the closed reduction and percutaneous pin group,and the open reduction group.Sixty-eight patients in the closed reduction and percutaneous pin group were treated with the modified Uhl technique,while fifty-two patients in the open reduction group were treated with open reduction and internal fixation using plates.The modified Sarmiento imaging score,Gartland-Werley wrist score,operation time,hospital stay,and treatment costs between the two groups were compared at a 6-month postoperative follow-up.Results There were no significant differences in terms of gender,age,affected side,injure factors,time of injury to surgery,Sarmiento imaging score,and Gartland-Werley wrist joint score(P>0.05).The closed reduction and percutaneous pin group exhibited an operation time of(35.88±14.11)minutes,hospitalization stay of(9.78±2.48)days,and treatment costs of(16074.91±1964.48)yuan,while the open reduction group demonstrated comparatively longer operation time of(65.48±14.26)minutes,hospitalization stay of(15.88±2.00)days,and treatment costs of(20451.27±1760.22)yuan(P<0.01).Conclusion The modified Uhl technique presents notable advantages in the management of Colles'fracture,including reliable fixation,less trauma,shorter operation time,less pain,shorter hospital stay,and cost-effectiveness.This technique exhibits promising potential for broader clinical application.However,it is important to note that the pin could potentially damage tendons,and in cases of Colles'fractures with osteoporosis and comminuted fragments,additional technique

关 键 词：中国接骨学 COLLES骨折 闭合穿针 改良Uhl技术 

分 类 号：R683[医药卫生—骨科学]