Purpose： To explore the advantages of palmar approach with Kirschner-wire （K-wire） fixation in the treatment of children＇s distal radius extension type fracture, Methods： Thirty patients, average age of 8.5 years...Purpose： To explore the advantages of palmar approach with Kirschner-wire （K-wire） fixation in the treatment of children＇s distal radius extension type fracture, Methods： Thirty patients, average age of 8.5 years ranging from 5 to 13 years, with distal radius extension type fracture and undergoing a failed manual reposition in our hospital were included, and treated by palmar approach with K-wire fixation between May 2014 and December 2017. Among these patients （21 male and 9 female）, 5 patients had chronic injuries over 10 days, and 6 patients had fracture of the distal radius epiphysis. The time between injury and treatment ranged from 1 to 30 days. Among them, 11 patients with right-sided fractures and 19 patients with left-sided fractures were operated via the palmar longitudinal incision approach. Results： The results were evaluated after an average of 18 months ranging from 5 to 36 months after operation. The recovery time of fracture was from 4 to 8 weeks and all incisions were primary healing with an average of 6 weeks. Nonunion, delayed union, early closure of distal radial epiphysis, and wrist varus/valgus deformity were not found in all the cases. Based on Gartland and Wereley wrist score assessment undertaken three months after operation, excellent scores were achieved in 24 cases, good scores in 3 cases, acceptable scores in 3 cases. Conclusion： The palmar approach with K-wire fixation via a front longitudinal incision in the treatment of children＇s distal radius extension type fracture has following advantages： （1） easy to reposition for both fresh and old fractures; （2） less damage to surrounding tissues and epiphysis; （3） quick recovery. It is suitable to treat children＇s distal radius extension type fracture.展开更多
目的:探讨经掌侧入路锁定加压钢板内固定治疗不稳定右桡骨远端骨折的临床疗效。方法:回顾性分析我院于2014年6月至2017年6月收治的行掌侧入路锁定加压钢板内固定治疗的不稳定右桡骨远端骨折患者53例,观察患者临床疗效、骨折愈合情况、...目的:探讨经掌侧入路锁定加压钢板内固定治疗不稳定右桡骨远端骨折的临床疗效。方法:回顾性分析我院于2014年6月至2017年6月收治的行掌侧入路锁定加压钢板内固定治疗的不稳定右桡骨远端骨折患者53例,观察患者临床疗效、骨折愈合情况、腕关节恢复情况、术后并发症发生情况。结果:末次随访根据Gartland and Werlkey功能评分发现手术治疗优良率为94.34%;末次随访患者掌倾角、尺偏角、桡骨长度相对术前均有明显改善(P<0.05); 53例患者术后均未见并发症发生;骨折愈合时间为(8.45±1.47)周;至末次随访,腕关节活动度恢复至健侧78%～100%,握力恢复至健侧72%～91%。结论:经掌侧入路锁定加压钢板内固定治疗不稳定右桡骨远端骨折临床疗效较好,可最大程度恢复桡骨长度、掌倾角、尺偏角,且术后腕关节恢复良好,术后未见并发症发生。展开更多
目的 对比分析微创经皮钢板接骨术与Henry入路钢板内固定治疗桡骨远端骨折的临床疗效.方法 选取我院于2011年3月～2012年10月收治的46例桡骨远端骨折的患者,将所有患者随机分为实验组与对照组,两组均为23例.实验组接受微创经皮钢板接骨...目的 对比分析微创经皮钢板接骨术与Henry入路钢板内固定治疗桡骨远端骨折的临床疗效.方法 选取我院于2011年3月～2012年10月收治的46例桡骨远端骨折的患者,将所有患者随机分为实验组与对照组,两组均为23例.实验组接受微创经皮钢板接骨术,对照组接受Henry入路钢板内固定,对比分析两组的临床疗效.结果 实验组术中出血及手术时间明显少于对照组[（37.83±2.96）mL、（37.52±10.17）min vs （53.24±7.61）mL、（66.32±9.95）min;t=9.051、9.708,P=0.000、0.000],两组术后并发症发生率的差异比较无统计学意义（13.0% vs 8.7%;χ2=1.247,P=0.264）;实验组与对照组骨折愈合时间及术后半年腕关节主动活动度的差异比较无统计学意义[（7.83±1.17）周,（71.92±7.31）°、（65.46±4.35）°、（81.59±4.72）°、（77.35±6.01）° vs （7.72±1.08）周,（71.25±6.83）°、（64.26±4.92）°、（80.62±4.88）°、（76.23±5.81）°;t=0.331、0.321、0.876、0.685、0.643,P=0.742、0.750、0.386、0.497、0.524],而术后半年实验组DASH评分明显低于对照组（6.21±2.34 vs 10.86±4.18;t=4.655,P=0.000）.结论微创经皮钢板接骨术治疗桡骨远端骨折具有出血少、时间短的优势,术后患者的主观满意程度较高,但对于部分骨折分型,仍需要采用Henry入路.展开更多
文摘Purpose： To explore the advantages of palmar approach with Kirschner-wire （K-wire） fixation in the treatment of children＇s distal radius extension type fracture, Methods： Thirty patients, average age of 8.5 years ranging from 5 to 13 years, with distal radius extension type fracture and undergoing a failed manual reposition in our hospital were included, and treated by palmar approach with K-wire fixation between May 2014 and December 2017. Among these patients （21 male and 9 female）, 5 patients had chronic injuries over 10 days, and 6 patients had fracture of the distal radius epiphysis. The time between injury and treatment ranged from 1 to 30 days. Among them, 11 patients with right-sided fractures and 19 patients with left-sided fractures were operated via the palmar longitudinal incision approach. Results： The results were evaluated after an average of 18 months ranging from 5 to 36 months after operation. The recovery time of fracture was from 4 to 8 weeks and all incisions were primary healing with an average of 6 weeks. Nonunion, delayed union, early closure of distal radial epiphysis, and wrist varus/valgus deformity were not found in all the cases. Based on Gartland and Wereley wrist score assessment undertaken three months after operation, excellent scores were achieved in 24 cases, good scores in 3 cases, acceptable scores in 3 cases. Conclusion： The palmar approach with K-wire fixation via a front longitudinal incision in the treatment of children＇s distal radius extension type fracture has following advantages： （1） easy to reposition for both fresh and old fractures; （2） less damage to surrounding tissues and epiphysis; （3） quick recovery. It is suitable to treat children＇s distal radius extension type fracture.
文摘目的:探讨经掌侧入路锁定加压钢板内固定治疗不稳定右桡骨远端骨折的临床疗效。方法:回顾性分析我院于2014年6月至2017年6月收治的行掌侧入路锁定加压钢板内固定治疗的不稳定右桡骨远端骨折患者53例,观察患者临床疗效、骨折愈合情况、腕关节恢复情况、术后并发症发生情况。结果:末次随访根据Gartland and Werlkey功能评分发现手术治疗优良率为94.34%;末次随访患者掌倾角、尺偏角、桡骨长度相对术前均有明显改善(P<0.05); 53例患者术后均未见并发症发生;骨折愈合时间为(8.45±1.47)周;至末次随访,腕关节活动度恢复至健侧78%～100%,握力恢复至健侧72%～91%。结论:经掌侧入路锁定加压钢板内固定治疗不稳定右桡骨远端骨折临床疗效较好,可最大程度恢复桡骨长度、掌倾角、尺偏角,且术后腕关节恢复良好,术后未见并发症发生。
文摘目的 对比分析微创经皮钢板接骨术与Henry入路钢板内固定治疗桡骨远端骨折的临床疗效.方法 选取我院于2011年3月～2012年10月收治的46例桡骨远端骨折的患者,将所有患者随机分为实验组与对照组,两组均为23例.实验组接受微创经皮钢板接骨术,对照组接受Henry入路钢板内固定,对比分析两组的临床疗效.结果 实验组术中出血及手术时间明显少于对照组[（37.83±2.96）mL、（37.52±10.17）min vs （53.24±7.61）mL、（66.32±9.95）min;t=9.051、9.708,P=0.000、0.000],两组术后并发症发生率的差异比较无统计学意义（13.0% vs 8.7%;χ2=1.247,P=0.264）;实验组与对照组骨折愈合时间及术后半年腕关节主动活动度的差异比较无统计学意义[（7.83±1.17）周,（71.92±7.31）°、（65.46±4.35）°、（81.59±4.72）°、（77.35±6.01）° vs （7.72±1.08）周,（71.25±6.83）°、（64.26±4.92）°、（80.62±4.88）°、（76.23±5.81）°;t=0.331、0.321、0.876、0.685、0.643,P=0.742、0.750、0.386、0.497、0.524],而术后半年实验组DASH评分明显低于对照组（6.21±2.34 vs 10.86±4.18;t=4.655,P=0.000）.结论微创经皮钢板接骨术治疗桡骨远端骨折具有出血少、时间短的优势,术后患者的主观满意程度较高,但对于部分骨折分型,仍需要采用Henry入路.
