摘要
目的探讨外固定架结合组合克氏针技术治疗不稳定性桡骨远端关节内骨折的方法及效果。方法对46例不稳定桡骨远端关节内骨折患者，采用外固定架结合组合克氏针技术进行治疗。按AO／ASW分型：C1型27例，C2型16例，C3型3例。根据改良的Samaiento评分，从掌倾角、尺偏角、桡骨短缩和关节面台阶方面对桡骨远端影像学进行评估；采用Gartland-Werley功能评分标准对腕关节功能进行评估，对结果进行统计学分析。结果所有患者均获得10～42个月的随访，平均25个月。掌倾角由术前（-18．5±10．2）。改善至术后（8．7±3．8）°，尺偏角由术前（一14．6±4．5）°改善至术后（17．5±6．1）°，桡骨短缩由术前（6．0±2．1）脚改善至术后（0．7±0．3）姗，关节面塌陷由术前（5．3±3．6）mm改善至术后（0．8±0．2）mm。按Sarmiento评分标准评定：优31例，良15例；按Gartlmd-Werley功能评分标准评定：优19例，良23例，可4例。结论外固定架结合组合克氏针技术是治疗不稳定性桡骨远端关节内骨折的一种有效方法．复位固定可靠，手术创伤小．可减少复位丢失。
Objective To explore the method and evaluate the effect of external fixator associated with combined Kirschner wire technique for the treatment of instable intra-artieular distal radial fractures. Methods Forty-six patients with instable intra-artieular distal radial fractures were treated with external fixator combined with Kirschner wire technique. According to AO/ASIF classification, there were 27 eases of type Cl fractures, 16 eases of type C2 fractures and 3 eases of type C3 fractures. The mdiographle parameters were evaluated according to modified Sarmiento scale regarding the volar tilt, radial inclination,radial shortening and stepping of the articular surface. Wrist function was assessed using Gartland-Werley scoring system. The results were statistically analyzed. Results All patients were successhtlly follow-up for 10 to 42 months with an average of 25 months. The volar tilt increased from （ - 18.5 ± 10.2）° to （8.7 ± 3.8）°,radial inclination increased from （ - 14.6±4.5）° to （17.5± 6.1）°, radial shortening decreased from （6.0 ± 2.1）ram to （0.7 ± 0.3）mm and articular surface stepping decreased from （5.3 ± 3.6）mm to （0.8± 0.2）mm. The radiographic manifestation was rated as excellent in 31 patients and good in 15 according to the Sarmiento scale. Garland-Werley functional assessment rated wrist function to be excellent in 19 patients, good in 23 and fair in 4. Conduslon External fixator associated with combined Kirschner wire technique is an effective method for treatment of dorsal instable intra-artieular distal radial fractures, which can provide successful reduction and reliable fixation. It causes less oncrative trauma and reduces reduction loss.
出处
《中华手外科杂志》
CSCD
北大核心
2011年第6期351-353,共3页
Chinese Journal of Hand Surgery
关键词
桡骨骨折
骨折固定术
外固定器
组合克氏针
Radius fractures
Fracture fixation
External fixators
Combined Kirsehner wire
