克氏针结合外固定支架治疗桡骨远端不稳定骨折

Minimally invasive surgical treatment of unstable distal radius fractures

目的探讨微创手术治疗桡骨远端不稳定骨折的临床疗效。方法回顾性分析自2003年5月采用克氏针结合外固定支架治疗的31例33侧桡骨远端不稳定骨折，男性12例，女性19例，年龄42～81岁，平均54．15岁。根据AO／SAIF分型：B1型2侧，B2型2侧，B3型4侧，C1型8侧，C2型12侧，C3型5侧。结果术后随访6～36个月，平均18个月，均获得骨折愈合且对位良好，患者术后腕关节活动范围明显改善，疗效依照Dienst功能评估标准进行评定：优22侧，良7侧，可4侧，优良率为88％。结论克氏针有限内固定结合外固定支架治疗桡骨远端不稳定骨折是一种微创手术，操作简单，固定可靠，疗效满意。

Objective To investigate the clinical effects of minimally invasive technique in the treatment of the unstable distal radius fractures. Methods From May 2003 in our department, 33 injured sides of 31 patients with unstable distal radius fractures were treated with external fixation combined with Kirschner wire fixation, 12 males and 19 females, aged from 42 to 81 years with an average age of 54.15 years. According to AO/ ASIF classification, there were 2 sides of type B1,2 sides of type B2, 4 sides of type B3, 8 sides of type C1, 12 sides of type C2, and 5 sides of type C3. Results All patients were followed up for average 18 months （ range from 6 to 36 months）. Bone union was achieved in all cases. The data were evaluated with Dienst scale system： 22 sides were graded as excellent, 7 good, and 4 fair. Conclusion External fixation combined with limited internal fixation in the treatment of the unstable distal radius fractures is a minimally invasive surgery. This procedure is simple and reliable in fixation, and can achieve excellent functional recovery.