桡骨远端骨折的治疗策略

Strategy for distal radial fracture treatment

桡骨远端骨折是常见骨折,也是容易受到忽视的骨折,治疗不当会产生明显的功能受限。我们根据桡骨远端骨折的AO分型,对不同骨折类型采取不同的治疗方案,并对患者进行随访,评价治疗效果,进而提出对此骨折的治疗方案。手法复位石膏托外固定适用于AO分型中A型和B1型的桡骨远端骨折。普通AO板钉固定的手术指征主要有3点:①AO分型中的A型骨折手法复位失败者,②AO分型中的B型骨折关节面移位明显者,③AO分型中的C1、C2型和部分C3型骨折。LCP板钉固定适于伴有严重骨质疏松的桡骨远端骨折和AO分型中的C2、C3型骨折。外固定架固定适用于粉碎性而无法行板钉固定的桡骨远端骨折。

The fracture of distal radius is so common that it tends to be ignored by orthopaedists, but inappropriate treatment often leads to severe complications. We treated different fractures of distal radius in different ways according to their specific AO classification and evaluated the outcomes by close follow up. Here based on our experience we put forward strategies for treating distal radius fractures. Close reduction and plaster cast immobilization are fit for fractures of type A and type B 1. The common AO plate and screw should be used under one of the following conditions: 1. Close reduction failed. 2. The joint surface of type B fracture displaces obviously. 3. Fractures of types C1, C2 and part of C3. LCP (locking compression plate) is usually used for fractures with osteopenia and of types C2 and C3. External fixators are applied in the cases whose fractures are too comminuted to perform plate and screw fixation.