锁定解剖钢板联合外固定支架治疗桡骨远端粉碎性骨折(1)
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2010年4月5日
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[摘要] 目的:研究一种治疗桡骨远端粉碎性骨折的方法。方法:2005年8月～2009年8月,应用锁定解剖钢板加外固定支架的方法治疗桡骨远端粉碎性骨折25例,早期指导功能锻炼,术后6～8周去除外固定。结果:术后1例出现腕部肿胀,1例锁定板螺钉切出关节腔,2例非锁定板螺钉松动,2例出现钉道感染,经处理治愈;术后25例随访6个月～2年,按Dienst功能评估标准,优19例,良4例,中2例,效果满意。结论:用锁定解剖钢板加外固定支架的方法治疗桡骨远端粉碎性骨折,是较早、较好恢复腕关节功能的方法。
[关键词] 桡骨远端粉碎性骨折;锁定解剖钢板;外固定支架;早期锻炼;功能恢复
[中图分类号] R683.41 [文献标识码]A [文章编号]1674-4721(2010)04(a)-022-03
Treatment of comminuted distal radius fractures with locking anatomical plate combined with external fixation
ZHANG Yi,XIE Qingxiang,LU Lifang
(Department of Orthopaedics, the TCM Hospital of Dongguan,Dongguan 523005, China)
[Abstract] Objective: To discuss the methods of the surgical treatment for comminuted distal radius fractures with the application of locking anatomical plate combined with the external fixation. Methods: From August 2005 to August 2009,25 cases with comminuted distal radial fractures were treated with the method mentioned above. Early functional exercises were undertaken under the guidance,and the external fixators were removed after 6 to 8 weeks postoperatively. Results: All of the patients were followed up average 6 to 24 months,the swelling of the wrist was found in 1 of the cases,in 1 case,the locking screw cut out of the articular cavity;2 cases were founded with loosening of the common screws;and another 2 cases suffered from the pin track infections.The recent follow-up based on the Dienst function evaluation system showed the satisfactory results with 19 excellent cases,4 good and 2 fair. Conclusion: The application of the locking anatomical plate combined with the external fixation shows excellent results for the comminuted distal radius fractures.It may be a good method for the early recovery of the wrist function.
[Key words] Distal radius comminuted fracture;Locking anatomical plate;External fixation;Early exercise;Function recovery
桡骨远端粉碎性骨折是桡骨远端骨折中的一种特殊类型,骨折一般涉及关节面,多见于骨质疏松的老年人,本院2005年8月～2009年8月,应用锁定解剖钢板加外固定支架的方法治疗桡骨远端粉碎性骨折25例,早期指导功能锻炼,术后6～8周去除外固定,腕功能恢复理想,效果满意。
1 资料与方法
1.1 一般资料
25例患者,男15例,女10例;年龄18～62岁,平均48.2岁;左手11例,右手14例;闭合伤22例,其中,手法复位失败后手术10例,粉碎严重无法复位直接手术12例,开放伤3例,均为GustiloⅠ型 ......
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