不稳定性桡骨远端骨折的手术治疗

Surgical treatment of unstable fractures of distal radius

目的探讨不稳定性桡骨远端骨折治疗方法及临床效果评价。方法回顾性分析2008年1月—2010年12月手术治疗桡骨远端不稳定骨折64例,根据AO分型及粉碎程度分别采用钢板内固定、外支架结合钢板内固定2种治疗方法。结果对59例平均随访18月。根据Cooney腕关节功能评价:优25例,良24例,可8例,差2例,优良率为83%。结论对不同桡骨远端不稳定骨折采用不同的手术方法,最大限度恢复桡骨与尺骨的相对长度、关节面的平整,掌倾角与尺偏角,术后配合合理的康复锻炼,能使腕关节功能得到最大恢复。

Objective To explore the surgical methods for unstable fractures of distal radius and evaluate the clinical results. Methods A retrospective analysis was conducted to 64 patients who received surgery for an unstable distal radius fractures from January 2008 to December 2010. According to the different types AO classification and comminution severity, two methods including plate fixation and external fixation plus plate fixation were employed. Results The average follow- up duration of 59 patients was 18 months. According to Cooney＇s assessment of the wrist, the re- sults were as follows： excellent in 25 cases, good in 24 cases, acceptable in 8 cases and poor in 2 cas- es, with an excellence rate of 83 %. Conclusion The surgical methods should be selected based on different types of unstable distal radius fractures. In the meantime, maximal recovery of the relative length of the radius and ulna, formation of articular surface, volar tilting angle and ulna inclination angle and reasonable rehabilitation exercises can make the wrist joint function get the maximum recovery.