摘要
背景:桡骨远端不稳定性骨折是老年人群最常见的骨折之一,如何处理此类桡骨远端关节内骨折,目前学术界仍存在争议。目的:观察闭合复位外固定支架修复桡骨远端AO C型骨折的临床效果、影像学结果和并发症。方法:2009年5月至2012年5月采用闭合复位外固定支架修复桡骨远端AO C型骨折患者122例(122腕),骨折根据AO分型:C1型16例,C2型63例,C3型43例。所有患者要求治疗后3,6,12周、1年、以后每年来院进行临床和影像学评估1次。采用改良Mc Bride评分系统评定腕关节功能。同时记录手术时间、住院天数、骨折愈合时间、腕关节功能及并发症发生率。拍摄腕关节正侧位X射线片进行影像学评估,以观察掌倾角、尺偏角、桡骨高度及关节面台阶(根据Knirck等分类标准)。结果与结论:122例患者均获随访,随访时间13-28个月。手术时间(19.1±11.2)min,透视时间(7.8±2.6)s,出血量(45.7±14.8)m L,住院天数(2.7±1.9)d,骨折愈合时间(3.1±0.7)个月。至末次随访时,改良Mc Bride评分为1-23分,平均6.7分,优良率62%;掌倾角10°-15°,平均(11.7±2.6)°;尺偏角18°-26°,平均(21.3±5.7)°;桡骨高度10-16 mm,平均(12.9±2.8)mm。关节面台阶根据Knirck等分类标准:1级108例;2级14例。共8例患者(6.6%)出现术后并发症,其中钉道感染6例,桡神经感觉支神经炎2例。提示采用闭合复位外固定支架治疗桡骨远端AO C型骨折创伤较小,住院天数较短,并发症轻微,骨折愈合较快,尤其适用于老年性桡骨远端AO C型骨折的修复。
BACKGROUND：Unstable distal radius fracture is the most common fracture in the elderly patients, how to treat this kind of intra-articular distal radius fracture remains controversial. OBJECTIVE：To summarize the clinical, radiographic outcomes and complications of closed reduction and external fixation of the AO type C distal radial fracture. METHODS：From May 2009 to May 2012, we performed closed reduction and external fixation in 122 patients （122 wrists） with the AO type C distal radial fractures. According to AO fracture classification：C1 in 16 patients, C2 in 63 patients, and C3 in 43 patients. The study participants underwent clinical and radiographical evaluation at 3, 6, 12 weeks, and 1 year postoperatively and annual y thereafter. Wrist joint function of patients was＆amp;nbsp;anteroposterior and lateral X-ray films by palmar angulation, ulnar variance, radial height, and quality of articular reduction according to Knirck’s classification. RESULTS AND CONCLUSION：Al 122 patients were fol owed up for 13 to 28 months. The mean operative time was 19.1±11.2 minutes;the mean fluoroscopy time was 7.8±2.6 seconds;the mean bleeding loss was 45.7±14.8 mL;the mean length of hospital stay was 2.7±1.9 days;the mean union time was 3.1±0.7 months. At the final fol ow-up, the average modified McBride score was 6.7 points （range, 1 to 23 points）, the rate of good to excel ent was 62%. The average palmar angulation was 11.7±2.6°; （range, 10°; to 15°）. The average ulnar variance was 21.3±5.7° （range, 18° to 26°）. The mean radial height was 12.9±2.8 mm （range, 10 to 16 mm）. Quality of articular reduction based on Knirck and Jupiter’s classification shows Stage 1 in 108 patients and Stage 2 in 14 patients. Eight patients （6.6%） suffered from postoperative complications, including pin tract infection in six patients, sensory branch of the radial nerve neuritis in two patients. Results verified that closed reduction and external fixation of the AO type C distal radial fracture
出处
《中国组织工程研究》
CAS
北大核心
2015年第35期5684-5690,共7页
Chinese Journal of Tissue Engineering Research
