手法整复加微创接骨板技术治疗桡骨远端粉碎性骨折

 目的 探讨手法整复加微创接骨板技术在治疗桡骨远端粉碎性骨折的应用效果.方法 在麻醉下手法整复桡骨远端骨折,依据骨折端复位情况选择手术入路,术中采用骨折撬拨复位、钢板解剖塑形、钢板潜行通过拇长和(或)拇短伸肌、旋前方肌与桡骨骨膜间隙等微创技术,尽量减少手术继发性创伤.结果 术后随访12个月,所有骨折均一期愈合,平均愈合时间8周(6～12周).末次随访: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54例,良28例,可4例,差0例.结论 在减少骨折部微循环损伤,确保骨折有效复位与固定,获得良好腕关节术后功能方面,手法整复间接复位加微创技术具有重要意义.

Treatment of comminuted distal radius fractures by longitudinal reduction and minimally invasive surgical plate fixation

Objective To study the clinical effects of longitudinal reduction with minimally invasive surgical plate for the comminuted fractures of distal radius. Methods Before the operation, all the fractures were reduced longitudinally under anesthesia, then were treated by means of minimally invasive plate osteosynthesis according to reduction condition and fracture types. Results Followed up for 12 months,the fractures were all healed by first intention. The mean healing time of the fractures was 8 weeks （6 - 12 weeks）. At last follow-up ,the mean range of motion of the wrist reached 50° of flexion,45° of extension,30° of ulnar deviation, 20° of radial deviation. According to the criteria of Gartland,the results were excellent in 54 cases, good in 28 cases, fair in 4 eases, and poor in 0 case. Conclusions Longitudinal reduction and minimelly invasive surgical plate fixation is vital in treating comminuted fractures of the distal radius, that can avoid large - area exposure of fracture site, minimize the damage to the soft tissue, reduce postoperative complication, and achieve good wrist function.