持续牵引在纠正桡骨远端不稳定骨折中桡骨短缩的作用机制探讨

Discussion of the mechanism of using continuous traction in treating unstable distal radius fracture

目的:探讨持续牵引在桡骨远端不稳定骨折治疗中的力学机制。方法:采用复位外固定器治疗30例桡骨远端不稳定骨折,男4例,女26例;年龄18～85岁,平均61岁。按AO分型,其中A3型12例,B2型3例,C1型8例,C2型4例,C3型3例。分别测量患者术前与术后X线上的桡骨茎突与尺骨关节面之间的距离。结果:30例患者获得6～15个月的随访,平均11.2个月。测量X线结果为术前平均(0.55±0.22)cm,术后平均(1.07±0.23)cm,明显高于术前,差异有统计学意义(P<0.01)。结论:复位外固定器提供的持续牵引其作用机制可以通过筋束骨理论、韧带整复原理及牵拉成骨理论解释。

Objective ：To explore the mechanism of continuous traction in treating unstable distal radius fracture. Methods：Thirty patients with unstable distal radius fractures were treated by diaplastic external fixator including 4 males and 26 females with an average age of 61 years ranging from 18 to 85 years. According to AO classification, 12 cases were type A3,3 were type B2,8 were type C 1,4 were type C2,3 were type C3. The distance of the processus radial malleolus and ulnar articularis were measured through X-ray examination. Results ：Thirty patients were followed-up for 6 to 15 months with an average of 11.2 months. The results of distance before treatment measuring in X-ray was （0.55±0.22）cm, and the distance after treatment was （1.07±0.23）cm. The distance after treatment was higher than the distance before treatment, there were significant difference between them（P〈0.01 ）. Conclusion： Continuous traction by diaplastic external fixator can explain by the theory of tendon reinforced bone and ligament restoration, or distraction osteogenesis.