桡骨远端不稳定型骨折的微创治疗

目的评估桡骨远端不稳定型骨折微创治疗的手术疗效。方法对64例桡骨远端不稳定型骨折患者进行回顾性研究,在手术后1～3年,测定腕关节的活动范围和影像学指标,对腕关节功能进行Gartland-Werley评分。结果患侧腕关节的背伸和尺偏活动范围显著小于正常腕关节（P〈0.05）,掌曲、桡偏、旋前和旋后活动范围与正常腕关节无显著性差异（P〉0.05）。掌倾角显著小于正常腕关节（P〈0.01）,桡骨高度和尺偏角无显著性差异（P〉0.05）。Gartland-Werley功能评分优良率为90.6%。结论闭合复位,外固定支架结合经皮克氏针固定能有效治疗桡骨远端不稳定型骨折。

Minimal Invasive Treatment of the Unstable Distal Radius Fracture

Objective To evaluate the efficiency of minimal invasive surgery in treating unstable distal radius fracture.Methods A retrospective study was conducted in 64 patients who had been treated with closed reduction and external fixation.Wrist movement range and radiographic index were measured and wrist function was evaluated by the Gartland-Werley criteria 1～3 years after the surgery.Results There was no significant difference in the movement range of flexion,pronation,supination and radial deviation,and no significant difference in the radial height and ulnar inclination(P>0.05) between the treated wrist joint and the normal hand.Nevertheless,the recovery of the wrist extension,ulanr deviation and palm tilt was limited,significantly smaller than the normal(P<0.05).By the Gartland-Werley criteria,the excellence rate was 90.6%.Conclusion The close reduction and fixation with external fixator augmented with K-wires is an effective ways to treat unstable distal radius fracture.