文档介绍：英文摘要
Results:The group were followed for
an
average time of 1 months.
Scoring system in all patients by prehensive fracture in the
plate group were excellent in 5 cases,good
in 1 case,B type fractures were
excellent in 12 cases,good in 14 cases,average in 1 case,C-type fractures
excellent in 3 cases,good in 2 cases,average in 3 cases,poor in of the
nail plate of which 1 case,symptoms of sensory branch of radial
nerve
in 1
case,pollicis longus tendon
injury
in
one
case,loss of reduction in 1
case.
B。type fracture with external fixation group excellent in 1 3 cases,good in 1 1
cases,average in 2
cases
and poor in I
case,C・type
fractures were excellent in
7 cases,good in 7 cases,average in 6 cases,poor in 7 cases,of which 1
case
of
nonunion,carpal
joint
stiffness in 3 cases,2
cases
of loss of fracture reduction.
Plate group,good rate of 0%.External fixator group rate of %fine.
Conclusions:Effect of Treatment in
two group
are
method of internal fixation should be used in B
external fixation should be used in C
type.
type,and
the method of
Key words:Distal radius;Fracture;Therapy;Effect;plate;external
fixation
4
临床分析
桡骨远端骨折治疗
随着社会的发展和老龄化趋势,桡骨远端骨折作为中老年常见的一
种骨折类型,其发病率不断上升,过去其治疗主要以保守治疗为主,虽取
得较为满意的效果,但也常常出现骨折畸形愈合和腕关节功能障碍等各种
并发症,随着人们对其认识的深入,治疗方案出现多样化。而对于具体骨
折采取何利I}台疗方案仍存在争议,
月行手术治疗患者的疗效进行回顾性分析。
临床资料
l一股资料
本组病例87侧,其中男性40t'N,女性47侧;年龄2l岁"-'72岁,平均
53岁。42例行钢板固定术,其中A型骨折6例,B型骨折27例,C型骨折9
例,锁定钢板13例,双钢板4例,植骨2例。行外固定架固定术45例,其中
B型骨折27例,C型骨折18例,包括7例有限切开克氏针加外固定架固定术,
植骨3例。
2治疗方法
臂丛麻醉后取仰卧位,大多采用腕掌侧入路,但在下述情况下选择背
侧入路:(I)AO分型中的B2型骨折(背侧Barton骨折)以及部分C2、C3
型骨折;(2)背侧粉碎骨折、估计复位后有明显的骨质缺损,需要术中背侧
植骨者;(3)背侧开放性骨折。以掌侧切口为例,于桡骨远端掌侧做纵行皮
肤切口,自桡骨干至远侧腕横纹,切断旋前方肌显露桡骨远端直视下整
复桡骨关节面恢复桡骨长度、掌倾角及尺偏角,并维持桡骨远端骨折块
正常的解剖位置,将适当长度的T型锁定钢板或普通T型钢板置于桡骨
的掌侧,以克氏针临时固定后,在定位器引导下用2~3枚锁定螺钉固定
远端骨折片,骨折近端用普通螺钉或锁定螺钉固定。其中患者有骨质缺损
较多者,可在术中取自体髂骨植骨或人工骨进行治疗。术后手术切