CAJ | 학술논문

目的应用掌侧入路治疗背侧移位的桡骨远端关节内骨折,评估蘑建桡腕关节面的完整性和稳定固定骨折的可靠性.方法 2003年8月至2008年5月,经掌侧入路治疗63例(65侧)背侧移位的桡骨远端关节内骨折,男20例(21侧),女43例(44侧);年龄18～82岁,平均年龄52.4岁,以老年居多.按照Frykman分类法,Ⅲ型骨折6侧,Ⅳ型骨折8侧,Ⅴ型骨折5侧,Ⅵ型骨折4侧,Ⅶ型骨折13侧,Ⅷ型骨折29侧.术中除采用桡腕关节造影术和标准的腕关节正侧位外,应用新的切线位的腕关节正侧位观察远端螺钉与关节面的关系.结果 53例(54侧)获得随访,随访时间5～47个月,平均16.4个月.按照Gartland和Werley评分,优32侧(59.3%),良14侧(25.9%),可7侧(13.O%),差1侧(1.8%),优良率85.2%.应用新的切线位的腕关节正侧位X线片显示42侧标准的腕关节正侧位的26侧正位和31侧侧位的远端螺钉进入关节.结论掌侧入路的方法对于大多数不同类型的桡骨远端关节内骨折是一种简单有效的治疗方法.
목적 응용장측입로치료배측이위적뇨골원단관절내골절,평고마건뇨완관절면적완정성화은정고정골절적가고성.방법 2003년8월지2008년5월,경장측입로치료63례(65측)배측이위적뇨골원단관절내골절,남20례(21측),녀43례(44측);년령18～82세,평균년령52.4세,이노년거다.안조Frykman분류법,Ⅲ형골절6측,Ⅳ형골절8측,Ⅴ형골절5측,Ⅵ형골절4측,Ⅶ형골절13측,Ⅷ형골절29측.술중제채용뇨완관절조영술화표준적완관절정측위외,응용신적절선위적완관절정측위관찰원단라정여관절면적관계.결과 53례(54측)획득수방,수방시간5～47개월,평균16.4개월.안조Gartland화Werley평분,우32측(59.3%),량14측(25.9%),가7측(13.O%),차1측(1.8%),우량솔85.2%.응용신적절선위적완관절정측위X선편현시42측표준적완관절정측위적26측정위화31측측위적원단라정진입관절.결론 장측입로적방법대우대다수불동류형적뇨골원단관절내골절시일충간단유효적치료방법.
Objective To treat dorsally displaced intra-articular fractures of the distal radius, and to assess the integrity of radiocarpal joint and the reliability of stable fixation fracture. Methods Sixty-three cases(65 sides)patients with dorsally displaced intra-articular fractures of the distal radius were performed operatively with the open reduction and internal fixation via palmar approach between August 2003 and May 2008. The series included 20 males(21 sides)and 43 females (44 sides). The mean age of patients was 52.4 years ranging from 18 to 82 years. According to the Frykman classification, 6 sides were of type Ⅲ, 8 of type Ⅳ, 5 of type Ⅴ, 4 of type Ⅵ, 13 of type Ⅶ and 29 of type Ⅷ. With the exception of the radiocarpal arthrography and the standard antero-posterior and lateral views of the wrist joint, two new tangential anteroposterior and lateral views of the wrist joint were intraoperatively described so as to observe the relation of the distal screws with the articular surface. Results The 53 cases (54 sides) of the 63 cases (65 sides) were followed up, and the follow-up time was averagely 16.4 months ranging from 4 to 47 months. According to Gartland and Werley criteria, 32 sides were rated as excellent(59.3%), 14 sides as good(25.9%), 7 fair (13.0%)and 1 poor(1.8%),and the excellent-good rate was 85.2%. Observing the new tangential anteroposterior and lateral views of the wrist joint,it showed that screws appeared penetrating into the radiocarpal joint in 26 of the 42 sides by standard antero-posterior view and in 31 of the 42 sides by standard lateral view. Conclusion This palmar approach represents a simple and valuable treatment methodology for the most frequent types of unstable fractures of the distal radius in young and elderly patients.