撑开器辅助复位克氏针内固定治疗桡骨远端骨折  

Distractor-assisted reduction and Kirschner wire internal fixation for treatment of distal radius fractures

作　　者：谭新欢 侯金永 毕宏政 高祥 杨凯 TAN Xin-huan;HOU Jin-yong;BI Hong-zheng;GAO Xiang;YANG Kai(WardⅡ,Dept of Bone and Hand Microsurgery,Shandong Wendeng Osteopathic Hospital,Weihai,Shandong 264400,China)

机构地区：[1]山东省文登整骨医院骨、手显微外科二病区,山东威海264400

出　　处：《临床骨科杂志》2024年第3期382-385,共4页Journal of Clinical Orthopaedics

基　　金：山东省中医药管理局计划项目(编号:2017-427);山东省中医药管理局中医药科技项目(编号:2020Z45、Z-2023032T);国家中医药管理局建设项目(国中医药人教函[2022]75号)。

摘　　要：目的探讨撑开器辅助复位克氏针内固定治疗桡骨远端C2型骨折的临床疗效。方法采用撑开器辅助复位克氏针内固定治疗320例桡骨远端C2型骨折患者。记录掌倾角、尺偏角、桡骨高度、骨折愈合及并发症发生情况,根据Gartland-Werley腕关节功能评分标准评价疗效。结果患者均获得随访,时间12~16个月。骨折临床愈合时间6~8(7.2±1.1)周,骨性愈合时间8~12(9.5±1.6)周。术后4例出现桡神经浅支损伤表现,8例出现针孔周围渗出伴红肿,均未出现骨髓炎、感染、骨折延期愈合或不愈合等并发症。末次随访时,掌倾角、尺偏角及桡骨高度均恢复正常或接近正常,与术后第2天比较差异均无统计学意义(P>0.05)。术后12个月根据Gartland-Werley腕关节评分标准进行疗效评定:优98例,良177例,可34例,差11例,优良率为85.9%。结论撑开器辅助复位克氏针内固定治疗桡骨远端C2型骨折具有操作简便、复位满意、固定牢靠、损伤小、并发症少的优点,腕关节功能恢复满意。Objective To investigate the clinical effect of the treatment of type C2 fractures of distal radius with distractor-assisted reduction and Kirschner wire internal fixation.Methods The 320 patients with type C2 fractures of distal radius were treated with distractor-assisted reduction and Kirschner wire internal fixation.Palmar inclination angle,ulnar deviation angle,radius height,fracture healing and complications were recorded.The therapeutic effect was evaluated according to the Gartland-Werley wrist function score.Results All patients were followed up for 12~16 months.The clinical healing time was 6~8(7.2±1.1)weeks,and the bony healing time was 8~12(9.5±1.6)weeks.Postoperative superficial branch injury of radial nerve occurred in 4 cases and peripinhole exudation with redness and swelling occurred in 8 cases.No complications such as osteomyelitis,infection,delayed or nonunion fracture occurred.At the last follow-up,the palmar inclination angle,ulnar deviation angle and radius height all returned to normal or near normal,which had statistical differences with the data of the second day after surgery(P>0.05).Twelve months after operation,the results were evaluated according to the Gartland-Werley wrist joint score:98 cases were excellent,177 cases were good,34 cases were fair,11 cases were poor,and the excellent-good rate was 85.9%.Conclusions In the treatment of type C2 fracture of distal radius,distractor-assisted reduction and Kirschner wire internal fixation have the advantages of simple operation,satisfactory reduction,firm fixation,less trauma and few complications,and satisfactory functional recovery of wrist joint.

关 键 词：桡骨远端骨折 克氏针内固定 

分 类 号：R683.41[医药卫生—骨科学] R687.32[医药卫生—外科学]