老年人桡骨远端粉碎性骨折手法整复结合手术治疗的应用

目的 探讨传统中医手法整复技术在老年人桡骨远端粉碎性骨折手术治疗中的临床应用.方法 对54例老年桡骨远端粉碎骨折患者,采用传统中医手法整复技术先行手法整复,其后依据现代骨折微创接骨板技术对骨折进行切开复位内固定治疗.结果术后随访12个月,所有骨折均l期愈合,愈合时间6～12周,平均8周.腕关节平均活动范围为掌屈50°,背伸45°,尺偏30°,桡偏20°.根据Gartland评分标准:优35例,良17例,一般2例,差0例.结论 术前采用传统中医手法整复技术对骨折进行预先整复,可以将复杂骨折转化成简单骨折,符合现代骨折间接复位加微创接骨生物学治疗理念,对减少骨折局部微循环损伤,确保骨折有效复位与固定,获得良好腕关节术后功能有一定意义.

Application of longitudinal reduction in surgical treatment of distal radius comminuted fractures in the elderly

Objective To discuss the application of longitudinal reduction of Chinese traditional medicine in surgical treatment of distal radius comminuted fractures in the elderly. Methods Before the operation, the 54 elderly patients with the fracture were reduced by longitudinal direction under anesthesia, then they were treated with minimally invasive plate osteosynthesis in the approach upon the reduction condition and fracture types. Results After 12-month follow-up, the fractures were all healed. The mean healing time of the fractures was 8 weeks (6-12 weeks). At the end of follow -up, the mean range of motion of the wrist was at 50°of flexion, 45°of extension, 30° of ulnar deviation, at 20° of radial deviation. According to the criteria of Gartland and Werley, the results were excellent in 35 cases, good in 17 cases, fair in 2 cases and poor in 0 case. Conclusions It is vital to provide a Chinese traditional longitudinal reduction before invasive surgical plate fixation in treatment of distal radius comminuted fractures, to avoid large-area exposure of fracture site, minimize the damage to the soft tissue, maintain reduction of post operation and achieve good wrist function.