髓内钉固定治疗桡骨远端骨折的疗效

Effect of intramedullary nail fixation in treatment of the distal radial fractures

目的探讨髓内钉固定治疗桡骨远端骨折的临床疗效。方法采用髓内钉固定治疗40例桡骨远端骨折患者。记录手术时间、术中出血量、骨折愈合时间、并发症发生情况、关节活动度、DASH上肢功能评分。结果患者均获得随访,时间12~18个月。手术时间55~70(64.6±3.2)min,术中出血量25~40(34.7±5.3)ml,骨折愈合时间3~8(4.8±2.6)个月。术后4例出现桡神经浅支损伤,经治疗后皮肤感觉恢复正常,无肌腱损伤、腕管综合征、骨不连等并发症发生。末次随访时,腕关节掌屈25°~70°、背伸50°~90°、桡偏15°~30°、尺偏20°~35°,前臂旋前80°~90°、旋后50°~90°;DASH上肢功能评分0~9(6.5±2.4)分,其中优38例,良2例。结论髓内钉固定治疗桡骨远端骨折具有创伤小、出血少、并发症少、患者腕关节功能恢复好等优点。

Objective To investigate the clinical effect of intramedullary nail fixation in the treatment of distal radial fractures.Methods A total of 40 patients with fractures of the distal radius who underwent intramedullary nail fixation were enrolled.The clinical outcome measures included the operation time,intraoperative blood loss,fracture healing time,complications,the range of motion of the joint,DASH upper limb function scores.Results All the patients were followed up for 12~18 months.The operation time was 55~70(64.6±3.2)min,intraoperative blood loss was25~40(34.7±5.3)ml and the fracture healing time was 3~8(4.8±2.6)months.Paraesthesia or dysaesthesia of the superficial radial nerve occurred in 4 patients,and the skin sensation recovered to the normal after the treatment,there was no one case of tendon rupture and carpal tunnel syndrome,nonunion.At the last follow-up,the wrist joint activity was that carpal flexion was 25°~70°,the dorsiflextion was 50°~90°,the radial deviation was 15°~30°,the ulnar deviation was 20°~35°,forearm pronation with 80°~90°,supination with 50°~90°,the DASH upper limb function scores was 0~9(6.5±2.4)points,among them 38 cases were excellent and 2 cases were good.Conclusions The intramedullary nail fixation has the advantages of less trauma,less bleeding and fast functional recovery in the treatment of distal radial fractures.