经皮穿针固定治疗桡骨远端骨折合并下尺桡关节脱位的临床研究  

Clinical Study on Percutaneous Needle Fixation in the Treatment of Distal Radial Fractures Complicated with Lower Ulnar Radial Joint Dislocation

作　　者：齐斐[1] 常乐[1] 冯世波[1] 李涛[1] 代妮 QI Fei;CHANG Le;FENG Shibo;LI Tao;DAI Ni(Department of Orthopedics,Wuhan Hankou Hospital,Wuhan,Hubei,China 430012)

机构地区：[1]湖北省武汉市汉口医院骨科,湖北武汉430012

出　　处：《中国药业》2023年第S01期143-146,共4页China Pharmaceuticals

摘　　要：目的探讨经皮穿针固定治疗桡骨远端骨折合并下尺桡关节脱位的临床疗效。方法选取医院2020年7月至2021年7月收治的桡骨远端骨折伴下尺桡关节脱位患者72例,均行经皮穿针固定治疗。结果随访4~24个月,骨折均骨性愈合;愈合一般、良好、优异的患者分别有6例、30例、36例,总优良率为91.67%;不良事件有克氏针松动、浅表性感染、桡神经感觉支损伤比例为4∶5∶2,分别经短臂石膏夹固定、口服抗菌药物及拔除克氏针处理后恢复良好,桡神经感觉支损伤患者术后30 d左右恢复状态改善;术后1年的腕关节活动度指标均更高,康复指标均更优(P<0.05)。结论经皮穿针固定术的应用,可提升桡骨远端骨折伴下尺桡关节脱位患者的康复效果。同时,患者的症状减轻,生活质量提升,具有显著的临床应用价值。Objective To investigate the clinical efficacy of percutaneous needle fixation in the treatment of distal radius fractures complicated with lower ulnar radial joint dislocation.Methods A total of 72 patients with distal radius fractures complicated with lower ulnar radial joint dislocation admitted to the hospital from July 2020 to July 2021 were selected.All the patients were given the percutaneous needle fixation treatment.Results After a follow-up of four to 24 months,all patients had bone healing.There were 6,30 and 36 patients with general,good,and excellent healing,respectively,with a total excellent and good rate of 91.67%.Adverse events included Kirschner wire loosening,superficial infection,and radial nerve sensory branch injury,with a ratio of 4∶5∶2.The above patients recovered well after treatment with short-arm plaster clip fixation,oral antibiotics and removal of Kirschner wire.The patients with radial nerve sensory branch injury recovered about 30 d after operation,and their wrist joint range of motion indicators were higher,the rehabilitation indicators were better one year after surgery(P<0.05).Conclusion The application of percutaneous needle fixation can improve the rehabilitation effect of patients with distal radius fractures complicated with lower ulnar radial joint dislocation.At the same time,the patient's symptoms have been alleviated,and their quality of life has been improved.Percutaneous needle fixation has significant clinical application value.

关 键 词：下尺桡关节脱位 桡骨远端骨折 经皮穿针 临床效果 

分 类 号：R274.1[医药卫生—中医骨伤科学]