桥式外固定支架治疗桡骨远端不稳定骨折42例疗效分析

Effect of bridging external fixator on unstable distal radius fractures

目的:探讨闭合复位、单侧桥式外固定支架治疗桡骨远端不稳定骨折的效果。方法:回顾性分析我科2005年7月～2010年6月应用单侧桥式外固定支架治疗42例桡骨远端不稳定骨折患者的临床资料,28例单纯手法牵引复位后行外固定支架固定,14例经皮克氏针撬拨复位固定加外固定支架固定,观察治疗效果。结果:骨折愈合时间6～9周,平均7.8周。5例出现针道浅表感染,经抗炎治疗及局部换药后好转。随访12～48个月(平均19个月),影像学评估(Stewart改良的Sarmiento评分):优32例,良10例。腕关节功能按Gartland与Werley功能评分标准:优29例,良9例,可4例,优良率90%。结论:闭合复位、单侧桥式外固定支架牵引固定桡骨远端不稳定性骨折是安全、有效的治疗方法,并可早期功能调整和训练。

Objective： To explore the effect closed reduction and unilateral bridging external fixator on the treatment of unstable distal radial fractures.Methods： Clinical data of 42 cases of unstable distal radius fracture admitted from July 2005 to June 2010,were analyzed retrospectively.There were 28 cases treated by manipulative reduction and external fixation and 14 cases treated by poking reduction of percutaneous Kirschner wire and external fixation.The efficacy was observed and compared.Results： The healing time was 6 to 9 weeks（averaging 7.8 weeks）.Five cases had superficial infection in pin tract,and were treated with anti-inflammatory treatment and local dress-changing.Follow-up of 12-48 months（average 19 months） showed 320excellent cases and 10 good cases according to the Sarmiento rating system modified by Stewart.The result of Gartland-Werley assessment showed 29 excellent cases,9 good ones and 4 fair cases,with excellent and good rate as 90%.Conclusion： Closed reduction and unilateral bridging external fixator is safe and effective method to treat unstable distal radius fractures.It is helpful in functional adjustment and training early of patients.