腕关节镜辅助治疗桡骨远端Die-punch骨折

Wrist arthroscopic treatment of Die-punch fracture of distal radius

目的:评价腕关节镜辅助下切开复位治疗桡骨远端Die-punch骨折的疗效。方法:自2015年12月至2017年5月收治50例桡骨远端Die-punch骨折患者,其中男31例,女19例;年龄20~45(34.12±2.56)岁。全部患者采用腕关节镜辅助下经掌侧入路切开复位掌侧钢板内固定手术,比较治疗前后腕关节活动范围以及Cooney腕关节功能评分。结果:50例患者均获得随访,平均18个月。DR断层扫描显示骨折全部愈合,桡骨轴向无短缩。发生3例切口感染,经处理全部消失。患者术后18个月腕关节活动范围均明显大于术前(P<0.05)。术后18个月Cooney腕关节功能评分均高于术前(P<0.05);优33例,良13例,可3例,差1例。结论:腕关节镜辅助下切开复位治疗桡骨远端Die-punch骨折能较好的恢复关节面的平整,有利于快速促进腕关节功能恢复,安全性较高,值得推广。

Objective:To evaluate the effect of open reduction assisted by wrist arthroscopy in the treatment of Die-punch fracture of the distal radius.Methods:The clinical data of 50 patients with die punch fracture of distal radius from December 2015 to May 2017 were analyzed retrospectively,including 31 males and 19 females,aged 20 to 45(34.12±2.56)years.All patients were treated with open reduction and internal fixation of volar plate through volar approach under the assistance of wrist arthroscope.The range of wrist movement and Cooney wrist function score before and after treatment were compared.Results:All patients were followed up with an average of 18 months.DR scan showed that all fractures healed and no shortening of radial axis.Three cases of incision infection occurred and disappeared after treatment.At 18 months after operation,the range of wrist movement was significantly larger than that before operation(P<0.05).At 18 months after operation,Cooney wrist function score was higher than that before operation(P<0.05),excellent in 33 cases,good in 13 cases,fair in 3 cases and poor in 1 case.Conclusion:The treatment of die punch fracture of the distal radius with open reduction assisted by arthroscopy can restore the flatness of the joint surface,promote the recovery of the function of the wrist joint quickly,and has high safety,which is worth popularizing.