腕关节外固定支架联合断端植骨治疗桡骨远端C型骨折的疗效分析

Efficacy of external wrist fixator combined with broken ends bone grafting on distal radius type C fractures

背景:桡骨远端C型骨折的手术方式选择存在争论,腕关节外固定支架适用于桡骨远端粉碎性骨折。目的:探讨采用腕关节外固定支架联合断端植骨治疗桡骨远端C型骨折的临床疗效。方法:2011年1月至2017年1月采用腕关节外固定支架联合断端植骨治疗桡骨远端C型骨折46例,男24例,女22例;年龄27～82岁,平均年龄(43.5±12.1)岁。骨折按AO分型,C2型12例,C3型34例。结果:全部患者均获得随访,随访时间为1.0～1.5年,平均(1.2±0.2)年。骨折愈合时间为6～8周,平均(6.5±0.2)周。参照Dienst功能评估标准评定疗效,46例中优30例,良11例,一般4例,差1例,优良率为89.1%。结论:采用腕关节外固定支架联合断端植骨治疗桡骨远端C2、C3型骨折,复位理想,固定可靠,桡骨关节面恢复平整,腕及手部功能恢复满意。

Background:The choice of operative fixation for type C distal radius fractures is controversial.External wrist fixator is suitable for complex comminuted distal radius fractures.Objective:To investigate the clinical effect of external wrist fixator combined with bone grafting on distal radius type C fracture.Methods:From January 2011 to January 2017,A total of 46 patients with distal radius type C fractures were treated with external wrist fixator and broken end bone grafting including 24 males and 22 females,ranging from 27 to 82 years old,with an average age of(43.5±12.1)years.According to AO classification of fracture,there were 12 patients of type C2 and 34 patients of type C3.Results:All patients were followed up for 1.0 to 1.5 years,with an average of(1.2±0.2)years.Fracture healing time was 6 to 8 weeks,with an average of(6.5±0.2)weeks.According to the Dienst function evaluation criteria,there were 30 patients of the excellent,11 patients of the good,4 patients in general,1 patient of the poor,and the excellent and good rate was 89.1%.Conclusions:External wrist fixation combined with bone grafting at broken end is effective in the treatment of distal radius fractures of C2 and C3 with the advantages of satisfactory reduction of fracture,reliable fixation,smooth articular surface of radius and the satisfactory function of wrist and hand.