河北医科大学学报

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有限克氏针辅助外固定架用于桡骨远端C型骨折中的可行性

陈斌   

  • 发布日期:2016-12-29

chenbin   

  • Published:2016-12-29

摘要: 目的:对有限克氏针辅助外固定架用于桡骨远端C型骨折中的可行性及疗效进行探究。 方法:以2012年3月-2014年3月来我院就诊的22例桡骨远端C型骨折手术治疗患者为对象, 采用有限克氏针辅助外固定架方法对患者进行治疗。并对患者进行平均12个月的随访,观察和记录患者骨折术后恢复情况。 结果:X线检查显示22例患者均显示痊愈,对固定架进行拆除的时间经过了5-11个月,平均7.1±0.3周。经测量后患者掌倾角与尺偏角平均值分别为(11.51±2.12)°与(24.32±1.75)°,在桡骨纵轴高度平均显示(10.84±2.26)mm,相比术前均有显著改善(P<0.05)。根据Aro等提出的方法对骨折复位质量进行评价,结果显示为优的患者14例,为良的患者5例,为可的患者3例,优良率为86.3%。根据Dienst等提出的标准对治疗效果进行评价,结果显示为为优的患者13例,为良的患者4例,为可的患者3例,为差的患者为2例,优良率为90.9%。接受手术3周之后,患者开始进行功能练习,在这一过程中有2位c3型骨折患者发生骨折移位,主要表现为掌倾角变小。及时实施复位后对患者进行克氏针辅助固定,经过一段时间的休养后再次检查显示全部愈合,不过其中1例在Dienst评分上结果显示为差。发生针孔感染的患者为1例,对其换药进行加强后很快症状便消失。手术过程及治疗过程中,任何一例患者均未发生过医源性神经血管损伤。 结论:在桡骨远端C型骨折的治疗中,对有限克氏针辅助外固定架法加以应用,对骨折复位后的稳定性有加强作用,能够促进骨折治愈率的提升机并发症发生率的减少,使患者关节功能得到满意恢复,值得临床推广应用。

Abstract: Objective: To explore the feasibility and efficacy of the external fixator for the treatment of type C fracture of distal radius. Methods: 22 cases of C type fracture of distal radius treated in our hospital from March 2012 to March in our hospital were treated with the method of -2014 assisted external fixator for the treatment of patients with distal radius fractures. And the patients were followed up for an average of 12 months. The patients were observed and recorded. Results: X-ray examination showed that 22 patients were cured, the time of removal of the fixed frame was 5-11 months, average 7.1 + 0.3 weeks. After measuring the volar tilt angle and ulnar deviation mean respectively (11.51 + 2.12) degree and (24.32 + 1.75) degree, in the longitudinal axis of the radial average height display (10.84 2.26 +) mm, compared to preoperative were significantly improved (P < 0.05). According to the method proposed by Aro et al. To evaluate the quality of fracture reduction, the results showed that 14 cases were excellent, 5 cases were good, 3 cases were available, the excellent and good rate was 86.3%. According to the criteria proposed by Dienst et al. To evaluate the therapeutic effect, the results showed that 13 cases were excellent, 4 cases were good, 3 cases were available, 2 cases were poor, the excellent and good rate was 90.9%. After 3 weeks of surgery, patients began functional exercises, in this process there are 2 patients with type C3 fractures of the fracture shift, mainly for the palm dip angle. After the implementation of the replacement of the patients with G's needle assisted fixation, after a period of rest after re examination showed all healed, but 1 of them in the Dienst score results show that the difference. Pinhole infection occurred in 1 patients, the dressing was strengthened after the symptoms quickly disappeared. In the course of operation and treatment, there were no iatrogenic injury of nerve and blood vessels in any patient. Conclusion: in the treatment of type C distal radius fractures, the limited Kirschner wire auxiliary fixation method, strengthened the role of can accelerate the cure rate of hoist complication rate of reduction of fracture, knee function recovered satisfactorily, is worthy of clinical application on the stability of fracture reduction.