桡骨远端骨折动力型外固定器的设计和应用

TheDesign and Clinical Application of A New Dynamic External Fixation Device for Fractures oftheDistal End of the Radius

目的研究外固定器治疗桡骨远端不稳定性骨折的有效性和适应证。方法自１９９６年１０月采用自行设计的动力型外固定器治疗不稳定性桡骨远端关节内粉碎性骨折３０例。结果经平均１１．４个月随访，复位质量优２２例、良７例、可１例，疗效优１９例、良９例、可２例。并发症３例（１０％）。结论（１）外固定器是治疗不稳定性桡骨远端骨折一种方便、有效的方法，动力型外固定器由于可早期活动腕关节，优势更为明显；（２）对固定欠稳定者，可辅以经皮克氏针固定，对并发症则可采取一些有效方法减少其发生；（３）不稳定性骨折，开放性骨折，石膏固定后再移位，桡骨轴向缩短超过３ｍｍ，伴有皮肤软组织挫伤或伴有正中神经损伤的骨折可作为外固定器治疗桡骨远端骨折的适应证。

Objective To investigate the feasibility and indications of the external fixation device fortreating unstable distal radius fractures. Methods Thirty cases of unstable comminuted intra-articular fractureof the distal end of the radius were treated with a new dynamic external fixation device. Results All patientswere followed up for anaverage of 11. 4 months. Anatomically, 22 patients had an excellent result, 7good, 1fair. And the excellent functional outcome was seen in 19 patients, good in 9 patients and fair in 2 patients.Three patients had complications: metacarpophalangeal fracture of the index finger occurred in 1, pin looseningdeveloped in 2. Conclusions The external fixation device was a convenient andeffective method. Espe-cially, it makes the early mobilization of wrist possible. If necessary, an additional Kischner wire might be usedto enhance the stability. The use of this new designed device is indicated in the cases of unstable fractures, openfractures, redisplacement after plaster immobilization, more than 3 mm axial shortening of the radius, fractureswithsoft tissue rupture, or the fractures with median nerve injuries.[