桡骨远端骨折的治疗

近年来,对于桡骨远端骨折的治疗观念不断更新,针对各种类型的桡骨远端骨折出现了不同的治疗方法,治疗手段不断完善。本文对桡骨远端的解剖、分类方法、治疗方法(包括闭合复位外固定、经皮穿针术、外固定架技术、切开复位内固定术、腕关节镜技术以及植骨技术的应用等)进行了综述。并对当前的治疗方法提出了几点看法:A型(AO分型)骨折首选闭合复位石膏外固定;对B型和C1型骨折在手法复位不满意的情况下首选切开复位斜T形钛板内固定;对C2和C3型骨折首选切开复位斜T形钛板内固定,干骺端粉碎无法进行钛板内固定时,采用切开复位外固定架固定术,并视术中情况决定是否使用克氏针内固定;对骨质疏松的老年患者采用LCP内固定,具体视骨折的骨缺损情况及骨质情况决定是否进行骨移植。

Treatment of distal radial fracture

Although fractures of distal radius are very common in clinic,new ideas,devices and methods in their treatment are constantly emerging.This review summarizes their classifications and treatment methods,including closed reduction and external fixation,percutaneous internal fixation,external fixation,open reduction and internal fixation,wrist joint arthroscopy and bone grafting.At last,the author puts forwards his opinions about the treatment based on AO classification:Close reduction and cast immobilization should be the first choice for type A fractures.Open reduction and internal plate fixation may be needed for type B and C1 ones when close reduction can not be satisfactory.Internal plate fixation and external fixation may be suitable for C2 and C3 ones.The locking compression plate may be used for old people with osteoporosis.The methods of treatment for distal radial fractures should vary according to the specific type of the fracture.Bone grafting may be considered on the condition of large bone defect or severe osteoporosis.