B、C型桡骨远端骨折的治疗

目的 探讨AO分类B、C型桡骨远端骨折的治疗方法。方法 对93例B、C型桡骨远端骨折采用手法复位石膏固定、闭合性复位经皮克氏针内固定及切开复位钢板螺钉内固定。结果 全部病例均随访2年以上。优良率：手法复位石膏固定组为82．05％，经皮克氏针内固定组为81．82％，切开复位钢板螺钉内固定组为80．95％。结论 手法复位能达到解剖或近似解剖复位并经石膏固定可达到良好固定者应采用非手术治疗；Bl、B3、C1型中的Colles骨折应采用闭合性复位经皮克氏针内固定；B2、Cl、C2型中的Simth骨折应采用切开复位钢板螺钉内固定；C3型骨折因干骺端粉碎应采用松质骨移植恢复桡骨的长度；伴有严重的骨质疏松的患者避免用内固定治疗。

Treatment of B,C-type fracture of the distal radius

Objective To discuss the treatment of AO type B and C fractures of the distal radius. Methods 93 displaced B, C type fractures of the distal radius were treated with closed reduction, percutaneous pin fixation and internal fixation with plates and screws, respectively. Results All the cases were followed up for over 2 years. The excellent and good result was found in 32 cases (82 05%) in closed reduction and plaster fixation group; 27 (81 82%) in percutaneous pin fixation group and 17 (80 95%) in internal fixation with plates and screws group. Conclusion Non operative treatment should be used to those who can attain and maintain anatomical reduction; The B 1, B 3 and C 1 types of Colles fractures are amenable to percutaneous pinning; Open reduction and internal fixation with plates and screws is suitable for AO type B 2, C 1 and C 2 fractures; And cancellous bone graft should be performed in severe comminuted fractures to restore the length of radius. Those with severe osteoporosis should avoid internal fixation.