手术治疗复杂桡骨远端骨折

目的 探讨治疗复杂桡骨远端骨折(AO分型的B型和C型)的方法. 方法 2005年6月-2007年6月手术治疗78例(83侧)复杂桡骨远端骨折,男51例,女27例;平均年龄34.6岁.按AO分型:B1型12侧,B2、B3型22侧,C1型21侧,C2型16侧,C3型12侧.手术采用切开直视下关节面复位、撬拨复位植骨支撑矫止桡骨远端掌倾角和尺偏角、应用外固定支架固定等方法. 结果 全部患者得到随访,平均随访时间10.5个月.术后关节面塌陷、移位均＜2 mm,掌倾角平均10.6°,尺偏角学均20.3°全部骨性愈合,以Garland and Werley评分方法评定腕关节功能:优33侧,良41侧,可7侧,差2侧,优良率89%. 结论 手术治疗可使关节而复位、可矫止掌倾角和尺偏角,应用外固定支架消除了前臂的轴向短缩应力,足治疗桡骨远端复杂骨折的有效疗法.

Surgical treatment of complex distal radius fracture

Objective To discuss methods treating complex distal radius fractures(types B and C fractures according to AO classification). Methods Seventy-eight patients(83 fracture parts)with complex distal tadius fractures were treated by surgical operation from June 2005 to June 2007.There were 51 males and 27 fenlalcs at an average age of 34.6 years.According to AO Classiiication.there were 12 typc B1 fractures,22 types B2 and B3,21 type C1,16 type C2 and 12 typc C3.The operation in-volved open reduction,external fixator,bone grafting for correcting the palm tilted angle and the ulna devi-ated angle. Results AIl patients were followed up for an average period of 10.5 months.After opera-tion the sinking or displacement of the articular surface was less than 2 mm.with average palm tilted an-gle of 10.6°and average ulna deviated angle of 20.3°.All fractures were healed.The ioint function was assessed by Gatrland and Werley score,which showed excellent result in 33 patients,good in 41.fair in 7 and poor in 2,with excellence rate of 89%. Conclusions Surgical operation is effective for treat-ment of complex distal radius fractures,for it can reduce the itaiured articular surface.correct the palm tilted angle and the ulna deviated angle and eliminate forearnl longitudinal shortening stress.