关节镜辅助下克氏针结合外固定支架治疗桡骨远端骨折

Kirschner wire combined with external fixators with arthroscopic assistance for treatment of distalradius fractures

目的探讨腕关节镜辅助下克氏针结合外固定支架治疗桡骨远端骨折的临床效果。方法自2013年6月至2016年10月，我们对30例桡骨远端骨折患者采用关节镜辅助下克氏针结合外固定支架治疗。统计患者骨折愈合时间，采用Mayo评分、DASH评分对患侧腕关节进行评估。结果所有患者均获得随访，时间为10．42个月，平均18．9个月。术后无感染、针道流脓、肌腱激惹等并发症。骨折愈合时间为9～13周，平均10-3周。末次随访Mayo腕关节功能评分87～95分，平均91．5分，其中优24例，良6例；DASH评分7～13分，平均10．9分。结论腕关节镜辅助下克氏针结合外固定支架治疗桡骨远端骨折具有微创、并发症少、便于患者早期功能锻炼等优点，疗效确切，值得临床推广。

Objective To investigate the clinical effects of Kirschner wire combined with external fixators with wrist arthroscopic assistance in the treatment of distal radius fractures. Methods From June 2013 to October 2016, 30 patients with distal radial fractures were treated by Kirschner wire combined with external fixators with wrist arthroscopic assistance. The fracture healing time was statistically analyzed, and the wrist function was evaluated by Mayo score and DASH score. Results All the patients were follow-up for 10 to 42 months with an average of 18.9 months. Postoperatively, no infection, needle track suppuration and tendon irritation occurred. The fracture healing time was 9 to 13 weeks with an average of 10.3 weeks. The final follow-up Mayo wrist function score was 87 to 95 （average, 91.5）. The results were excellent in 24 cases and good in 6 cases. DASH score was 7 to 13 （average, I0.9）. Conclusion Kirschner wire combined with external fixators with arthroscopic assistance for treatment of distal radius fractures has the advantages of minimally invasive, less complications, easy for patients with early functional exercise and so on, which is effective and worthy of clinical promotion.