万向式骨外固定器治疗桡骨远端不稳定性骨折的临床应用

Clinical application of external fixation in treating unstable distal radius fracture

目的评价万向式骨外固定器治疗桡骨远端不稳定骨折的疗效。方法应用万向式桡骨远端骨外固定器治疗159例(145人次)桡骨远端不稳定骨折,53例因骨折严重外加克氏针固定,11例因关节面塌陷骨缺损同时采取植骨。结果随访时间12～28个月,平均随访18.12个月,按Dienst等推荐的测量方法制定的解剖评估标准、功能评估标准及影像学评估标准,解剖复位优良者147例,优良率92.45%;功能优良者148例,优良率93.08%。结论应用万向式骨外固定器治疗桡骨远端不稳定骨折是目前理想的手术方法。同时验证了此万向式骨外固定器的灵活性、可操作性及固定后的稳定性,尤其适合于广大基层医院推广。

Objective To evaluate the clinical application of external fixation in the treatment of unstable distal radius fracture. Methods 159 cases（ 145 person-time） with unstable distal radius fractures were treated with external fixation. 53 cases of them were also fixed with K-wires, and bone graft was used in 11 cases with severe bone defect. Results The patients were followed up for 12 -28 months. An average period was 18.12 months. According to Dienst＇ s method, modified anatomic evaluation standard, functional and imaging evalua- tion standard, 147 cases showed excellent or good results of anatomic recovery, with effective rate 92.45%. 148 cases showed excellent or good results according with functional evaluation standard,with effective rate 93.08%. Conclusion External fixation is a ideal method to treat unstable distal radius fracture. The kind of external fixation is easy to manufacture and can acquire reliable fixation, dispense with twice operation, so it is worth to be widely used in clinic.