手法复位联合微创组合式外固定支架在尺桡骨远端粉碎骨折中应用.docVIP

手法复位联合微创组合式外固定支架在尺桡骨远端粉碎骨折中应用 　　[摘要] 目的 探?手法复位联合微创组合式外固定支架在尺桡骨远端粉碎骨折中的应用。 方法 选取我院2013年3月～2016年3月尺桡骨远端粉碎骨折患者70例作为研究对象，根据手术方法的不同分为对照组（n=31）和研究组（n=39），对照组给予传统手法复位配合石膏外固定的治疗方法治疗，研究组给予传统手法复位联合微创组合式外固定支架治疗，术后均随访9个月。比较两组患者术前术后桡骨尺偏角、掌倾角及桡骨高度恢复情况，并采用 Sarmiento Colles骨折疗效评分系统评估两组患者的骨折复位效果，采用 Dienst评分系统评定腕关节的功能恢复的优良情况，并观察术后两组患者的并发症发生情况。 结果 研究组术后桡骨尺偏角、掌倾角及桡骨高度恢复情况均优于对照组（P0.05）；研究组术后骨折复位优良率为97.43%（38/39）明显优于对照组77.41%（24/31）（P0.05）；研究组腕关节的功能恢复优良率为94.87%（37/39）明显优于对照组74.19%（23/31）（P0.05）；研究组术后并发症疼痛、腕关节僵硬、桡骨短缩、骨折移位、畸形愈合及创伤性关节炎等发生总率5.12%（2/39）明显低于对照组25.80%（8/31）（P0.05）。 结论 手法复位联合微创组合式外固定支架在尺桡骨远端粉碎骨折中的应用，治疗效果显著，可有效促进骨折愈合，恢复腕关节功能，提高骨折稳定性，减少骨折复位后再移位等并发症，是一种安全微创的治疗方法。 　　[关键词] 手法复位；微创；组合式外固定支架；尺桡骨远端粉碎骨折 　　[中图分类号] R687.3 [文献标识码] A [文章编号] 2095-0616（2017）10-200-04 　　Application of manual reduction combined with minimally invasive external fixator in the treatment of comminuted fracture of distal radius and ulna 　　HUANG Wuquan 　　The Eighth Peoples Hospital of Nanhai District， Guangdong Province， Foshan 528216， China 　　[Abstract] Objective To explore the application of manual reduction combined with minimally invasive external fixator in the treatment of comminuted fractures of distal radius and ulna. Methods 70 cases of comminuted fractures of distal radius and ulna from March 2013 to March 2016 in our hospital were selected as the research object. The patients were divided into control group （n=31） and study group （n=39） according to the different surgical methods. The control group was treated with traditional manipulative reduction and plaster external fixation. The study group was treated with traditional manipulative reduction combined with minimally invasive external fixator. All patients were followed up for 9 months. Operation of the two groups were compared before and after operation of ulnar inclination， palmar tilt and radial height recovery. Sarmiento Colles fracture efficacy scoring system was used to evaluate the effect of two groups. Dienst scoring system was used to e