桡骨远端经关节面粉碎性骨折的诊治

Diagnosis and Treatment of Distal Radial Transarticular-surface Comminuted Fracture

目的 :为探索桡骨远端经关节面粉碎性骨折的诊治进展。方法 :在 1999年 1月 1日～ 2 0 0 2年 6月 2 0日期间共收治 5 8例 6 1肢 ,予手法复位后小夹板、石膏夹板、外固定架固定 ,切开复位“T”形、斜“T”形钢板、克氏针加石膏或外固定架固定等方法治疗。结果 :对 4 2例 4 4肢进行 5～ 2 4个月随访 ,全部病例均骨愈合 ,平均愈合时间 6 .2周 ,掌倾角、尺偏角基本恢复 ,腕关节功能恢复理想。结论 :桡骨远端经关节面粉碎性骨折 ,只要将传统的手法复位 ,夹板、石膏固定与较先进的外固定架固定 ,切开复位后“T”形、斜“T”形钢板内固定等方法相结合 ,并早期加强功能锻炼 。

Objective:To study the diagnosis and treatment of distal radial transarticular-surface comminuted fracture.Methods:From January 1999 to June 2002,58 patients (61 limbs) with distal radial transarticular-surface comminuted fractures were treated.38 patients (40 limbs) were reducted and fixed with external splint,plaster and external fixtor.20 patients (21 limbs)were reducted open and fixed with internal “T” or oblique “T”plate and kirschner wire,internal fixation must be combined with plaster or external fixtor some times.Results:42 cases(44 limbs)were followed-up for average 10 months(range 5～24 months) and all united well.The bone union of roentgraphic evidence was at 4.5～16 weeks(average 6.2 weeks).The function of flexion and extension of carpal joints were achieved satisfactorily.Conclusion:For the patients with distal radial transarticular-surface comminuted fracture,the close or open reduction and external or internal fixation,in combination with early rehabilitation can obtain satisfactory treatment outcome.