外固定器治疗桡骨远端C2、C3型不稳定骨折

Treatment of AO C2 and C3 distal radius fractures with external fixation

目的 探讨外固定器＋有限内固定治疗桡骨远端C2、C3型不稳定骨折的临床疗效。方法 应用外固定器治疗桡骨远端粉碎性不稳定骨折24例。手法牵引复位＋外固定架11例；克氏针撬拨复位＋外固定架9例；尺骨内固定＋外固定架1例；掌侧钢板＋外固定架3例。结果 24例均获随访，时间4—35个月。用Dienst标准评估腕关节功能，优8例，良13例，一般2例，差1例。用Stewartetal标准进行影像学评估，优8例，良11例，一般3例，差2例。钉道感染1例，无钉道骨折、医源性神经管损伤、伤口感染、骨髓炎等并发症发生。结论 外固定器＋有限内固定是治疗桡骨远端C2、C3型粉碎性不稳定骨折的有效方法，其操作简便，疗效可靠，并发症少。

Objectives To study the clinical efficacy of external fixator combined with limited internal fixation in the treatment of AO C2 and C3 distal radius fractures with external fixation combined by limited internal fixation. Methods Twenty-four patients with serious comminuted distal radius fractures were treated by external fixator.. Reduction was achieved and maintained in 4 ways： 11 with longitudinal traction and external fixation; 9 with external fixation and percutaneous K-wires; 1 with external fixation and ulnar internal fixation and 3 with external fixation and volar plate fixation. Results All the 24 patients were followed up from 4 to 34 months. The clinical and radiographic re- suits were assessed according to the Dienst＇s and Stewart＇s criteria, According to the Dienst＇s criteria, there were 8 excellent,13 good,2 fair and,1 poor; According to the Stewart＇s criteria, there were 8 excellent,ll good,3 fair, and 2 poor. Pin tract infection was found in 1. No pin tract fracture,itrogenic nerve and vascular injure,wound infection or osteomyelitis was found. Conclusions The treatment of distal radius AO C2 and C3 fractures using external fixator combined with limited internal fixation is of easy performance, satisfactory efficacy and lower complications.