桡骨远端不稳定骨折的手术治疗

目的 探讨桡骨远端不稳定骨折的手术治疗方法及临床效果评价.方法 回顾性分析2001年5月-2008年7月手术治疗桡骨远端不稳定性骨折87例,根据AO分型的不同类型骨折及其粉碎程度分别采用钢板内固定、外固定支架辅以克氏针固定以及钢板内固定联合外固定毒架等三种不同的治疗方法.结果 对78例患者平均随访18个月.根据Cooney腕关节功能评价:优44例,良21例,可11例,差2例,优良率为83%.结论 对不同类型桡骨远端不稳定骨折采用不同的手术方法,最大限度恢复桡骨与尺骨的相对长度、关节面的平整、掌倾角及尺偏角,术后配合合理的康复锻炼,能使腕关节功能得到最大恢复.

Surgical treatment of unstable fractures of distal radius

Objective To explore the surgical methods for unstable fractures of distal radius and evaluate the clinical results. Methods A retrospective analysis was conducted on 87 patients with unstable fractures of distal radius treated surgically from May 2001 to June 2008. According to AO classification and comminution severity, three methods including plate fixation, external fixation and Kirschner' s pins and plate fixation plus external fixation were employed accordingly. Results Of all, 78 patients were followed up for average 18 months. The result of Cooney's assessment of the wrist was excellent in 44 patients, good in 21, fair in 11 and poor in 2, with excellence rate of 83%. Conclusions The surgical methods should be selected based on different types of unstable distal radius fractures. In the meantime, maximal recovery of the relative length of the radius and ulna, formation of articular surface, volar tilting angle and ulnar inclination angle and reasonable rehabilitation exercises are helpful for the functional recovery of the wrist to a largest extent.