摘要
目的探讨外固定架治疗桡骨远端骨折术后并发症发生原因及其防治策略。方法回顾性分析在我院行外固定架治疗且出现术后并发症的桡骨远端骨折36例临床资料。结果 36例中发生骨折再移位10例(27.8%),未达解剖学复位;发生关节面不平整、关节僵硬及创伤性关节炎9例(25.0%),经理疗或二次手术后关节疼痛症状好转;针道感染8例(22.2%),经应用抗生素及定时换药后感染得以控制;神经损伤及伸拇肌腱损伤各3例(8.3%),行消肿及神经、肌腱缝合修补术后好转;第二掌骨医源性骨折3例(8.3%),给予石膏外固定痊愈。结论熟练掌握桡骨远端及腕关节解剖结构,术中仔细操作、正确安装外固定架并避免可能导致的并发症,是提高手术安全性的重要措施。并发症发生后及时有效处理,避免造成严重后果。
Objective To investigate causes of postoperative complications and prevention of external fixator in treatment of patients with distal radius fractures. Methods Clinical data of 36 distal radius fractures patients with postoperative complications treated by external fixation was retrospectively analyzed. Results Among 36 patients, 10 patients （27.8%） had re-displacement without reaching index of anatomic reposition; 9 patients （25.0%） had uneven articular surface, joint stiffness and traumatic arthritis, and arthralgia symptoms were improved after physical therapy or the second operation; 8 patients （22.2%） had pin tract infection, and infection was controlled after treatment with antibiotics and dressing change regularly; neural injury and thumb injury of extended tendon were found in 3 patients （8.3%） respectively, and the injuries were improved after disperse swelling, and suturation and kposthesis for nerves and tendons ; the second metacarpal iatrogenic fracture was found in 3 patients （8.3%）, and fracture recovered after treatment by plaster external fixation. Conclusion Possible complications may be avoided by well understanding anatomical structure of distal radius and wrist, and carefully operate and install external fixator correctly, and it is also an important method for improving surgical safety. Effective treatment in time after pathogenesy of complications can avoid serious consequences of complications.
作者
康强军
刘长安
刘国辉
王洪彬
王凌云
KANG Qiang-jun LIU Chang-an LIU Guo-hui WANG Hong-bin WANG Ling-yun(The First Department of Osteology, Bethune International Peace Hospital of PLA, Shijiazhuang 050082, Chin)
出处
《临床误诊误治》
2016年第10期73-75,共3页
Clinical Misdiagnosis & Mistherapy
关键词
外固定器
桡骨骨折
手术后并发症
External fixators
Radius fractures
Postoperative complications
