外固定支架持续超关节牵引弹性固定治疗桡骨远端粉碎性骨折的疗效及可行性

The efficacy and feasibility of external fixation with continuous hyperarticular traction and elastic fixation in the treatment of comminuted distal radius fractures

目的探讨采用外固定支架持续超关节牵引弹性固定的方法治疗桡骨远端不稳定的粉碎性骨折的效果及可行性。方法选取本院2015年1月至2018年6月收治的难以闭合复位固定甚至开放手术也不易固定的桡骨远端粉碎性骨折患者30例,采用在闭合状态下于第二掌骨近端及桡骨骨折线近端分别打入2枚外固定支架螺钉,并利用外固定支架持续超关节牵引复位及弹性固定的方法治疗,随访并参考Dicnst功能评估标准评定治疗后的疗效。结果30例患者均获随访,其中优18例,良9例,可2例,差1例,优良率90%。结论采用外固定支架持续超关节牵引弹性固定的方法治疗桡骨远端不稳定的粉碎性骨折方法简单、微创、实用、治疗效果好、可操作性强,适合在广大的基层医院推广应用,有较高的临床应用价值。

Objective To explore the effect and feasibility of external fixator for the treatment of unstable comminuted fracture of distal radius by continuous hyperarticular traction and elastic fixation.Methods 30 cases of patients with comminuted distal radius fracture from January 2015 to June 2018 were selected in our hospital,which was difficult to be closed reduction and fixation or even open surgery,two external fixator screw were inserted into the proximal end of the second metacarpal bone and the proximal end of the radius fracture line respectively in the closed state.The rigid comminuted distal radius fracture was treated by continuous hyperarticular traction reduction and elastic fixation with external fixator..Heavy fracture.Followed up and evaluated the effect of treatment with dicnst function evaluation standard.Results 30 cases all followed up for 7 months,18 cases were excellent,9 cases were good,2 cases were fair and 1 case was poor,the excellent rate was 90%.Conclusion The method of continuous hyperarticular traction and elastic fixation with external fixator is simple,practical,minimally invasive and effective in the treatment of unstable comminuted distal radius fractures.It is especially suitable for popularization and application in grass-roots hospitals and has high clinical application value.