外固定架牵拉成骨技术治疗桡骨远端粉碎性骨折

External fixators and distraction osteogenesis for treatment of comminuted fracture of distal radius

目的探讨应用外固定架牵拉成骨技术治疗中老年桡骨远端粉碎性骨折的方法及疗效。方法收集2002年1月至2008年8月95例中老年桡骨远端粉碎性骨折患者应用外固定架牵拉成骨技术治疗的临床资料,评价其疗效。17例采用手法复位石膏外固定,因手部肿胀放松外固定后骨折移位,1周内改用外固定架固定;78例直接予外固定架固定。结果92例患者获随访13～36个月,平均26个月,观察骨折愈合情况和腕关节功能情况,平均骨折愈合时间4.2周。按Dienst功能评估标准进行疗效评定,优良率92.4%。结论外固定架牵拉成骨技术治疗中老年桡骨远端粉碎性骨折,具有良好的固定作用和促进骨愈合作用,能较好防止骨折畸形愈合和保护腕关节功能。

ObjectiveTo investigate therapeutic effects of external fixator and distraction osteogenesis on comminuted fracture of distal radius in middle and old-aged persons.MethodsClinical data of 95 patients with comminuted fracture of distal radius treated with external fixator and distraction osteogenesis were recruited and analyzed for assessing its therapeutic effects.ResultsOf 95 patients,17 were treated with manual reduction and plaster immobilization first,then changed with external fixator to fix within 1 week for fracture displacement after loosening external fixator due to swelling of hand,and 78 were directly treated with external fixator.A total of 92 patients were followed up for observing fracture healing and function of wrist joint,and the average duration of follow-up was 26 months（range：13 to 36 months）.The mean time of fracture union was 4.2 weeks.According to Dienst criteria,the excellent rate was 92.4%.ConclusionsExternal fixator and distraction osteogenesis for treatment of comminuted fracture of distal radius in the middle and old-aged patients can play a good role to fix and promote bone healing,prevent fracture malunion and protect wrist joint from dysfunction.