闭合复位克氏针经皮内固定结合外固定器治疗桡骨远端粉碎性骨折临床的研究.docVIP

闭合复位克氏针经皮内固定结合外固定器治疗桡骨远端粉碎性骨折临床的研究 　　【摘要】 目的：探讨闭合复位克氏针经皮内固定结合外固定器治疗桡骨远端粉碎性骨折的手术效果及安全性。方法：选取2010年5月-2013年 　　3月笔者所在医院采用手法复位、克氏针经皮内固定并结合外固定器治疗的桡骨远端粉碎性骨折103例，全部病例均为闭合性损伤，按AO分类属于A3型15例、B型50例、C型38例。结果：103例患者平均随访6个月（3～9个月），骨折均愈合。本组103例中优42例，占40.78%；良49例，占47.57%；中差12例，占11.65%；优良率为88.35%。结论：闭合性复位、克氏针经皮内固定并结合外固定器治疗桡骨远端粉碎性骨折，是一种非常有效，且较理想的手术方法，值得临床应用推广。 　　【关键词】 闭合复位； 克氏针； 外固定器； 桡骨远端粉碎性骨折 　　中图分类号 R683.41 文献标识码 B 文章编号 1674-6805（2016）11-0009-03 　　【Abstract】 Objective：To evaluate the surgical efficacy and safety of the closed reduction and percutaneous fixation with kirschner wire combined with external fixator in the Treatment of distal radius comminuted fracture.Method：From May 2010 to March 2013，103 cases of distal radius comminuted fracture who were treated with the closed reduction and percutaneous fixation with kirschner wire combined with external fixator were selected，all cases were closed injury，according to AO classification，15 patients belonged to type A3，50 cases of type B，type C were 38 cases.Result：103 patients were followed up for 6 months on average（3 to 9 months），fractures were healing.The superior were 42 cases in 103 cases，accounted for 40.78%，49 cases of good，accounted for 47.57%，medium and poor were 12 cases，accounted for 11.65%，the excellent rate was 88.35%.Conclusion：The closed reduction and percutaneous fixation with kirschner wire combined with external fixator in the treatment of distal radius comminuted fracture is a very effective ideal surgical method，worth clinical promotion. 　　【Key words】 Closed reduction； Kirschner wire； External fixator； Distal radius comminuted fracture 　　First-author’s address：Laixi Traditional Chinese Medicine Hospital，Laixi 266600，China. 　　doi：10.14033/j.cnki.cfmr.2016.11.005 　　桡骨远端骨折是指发生于旋前方肌近侧缘以远的骨折，约占全身骨折的1/6，也是上肢最常见的骨折，其中50%为关节内骨折[1-2]。目前治疗桡骨远端骨折仍以传统的手法复位、石膏外固定居多，此方法对桡骨远端关节外的简单骨折可以获得较为满意的疗效，但对不稳定的桡骨远端粉碎性骨折，尤其是关节内骨折，单纯的石膏外固定是很难做到关节面良好的对位和稳定的固定，进而造成桡腕及桡尺关节骨性创伤性关节炎[2]。近年来，随着科学技术的发展和人们对腕部生物力学及解剖知识的增多，内固定技术也随着有了新的进展[2-3