Barton骨折手法复位稳定性的实验研究

目的：作者通过Barton骨折模型，利用压力传感器测定骨折端压力，证实Barton骨折的手法整复原则。方法：采用4例正常青年新鲜上肢标本，采用压力传感器，直接置于骨折断端，分析不同的固定角度对骨折端稳定性的影响。结果：掌侧型Barton骨折在掌屈位时压力随固定角度的增大而增大，背伸位固定时随固定角度的增大而减小，旋后位时骨端压力比旋前位时明显增大；背侧型Barton骨折则相反。表明复位固定与受伤方向相反。断裂其对侧腕掌或腕背韧带后发现骨折断端压力变化不稳定。结论：背侧型骨折应固定在背伸位、前臂旋前位时角度越大越稳定，掌侧型骨折应固定在掌屈位、前臂旋后位时角度越大越稳定。断裂其对侧腕掌或腕背的韧带以后骨折断端的稳定性值得怀疑，大多应行手术治疗。

Experimental Study of Reduction and Fixation of Bartons Fractures

Objective:To observe the reduction and fixation angles of Bartons fractures by pressure mensuration and X-ray photograph of the models.Methods:Took 4 fresh upper limb specimens to make anterior and posterior marginal fracture-dislocations of the distal ends of radius.With pressure transducer to determine the pressure of the fractural ends and took X-ray photograph.Then analyzed the different reduciton angles which affect the stability of the fractures.Results:The pressure of volar Bartons fractures increased as angles increasing by volar flexion,and then decreased with the wrist in dorsiflexion.The pressure of dorsal Bartons fractures increased as angles increasing with the wrist in dorsiflexion,and then decreased by volar flexion.On the other hand,X-ray also indicated the direction of reduction and fixation was reverse to the direction of injury.When the ligaments were rupture the pressures were unstable in the fracture ends,so the stability of the frature is doubtful.Conclusion:Dorsal fractures should be fixed at dorsiflexion and forearm proxation and volar fractures should be fixed at volar flexion and forearm supination to get stability.