CAJ | 학술논문

目的分析陈旧性Barton骨折的原因,探讨其检查与处理方法.方法对16例陈旧性Barton骨折(掌侧骨折11例,背侧骨折5例),通过x线片检查并结合CT检查确定骨折的类型.关节面的移位程度和腕关节脱位程度.11例掌侧骨折采用掌桡侧切口T型金属板固定,5例背侧骨折采用桡骨远端背外侧切口有限内固定加外固定架固定.结果术后随访时间为10～36个月,平均12.5个月.X线片显示骨折全部愈合,腕关节面掌倾角为10°～15°,平均11.3°;尺偏角16°～25°,平均20°;桡骨轴向无短缩.按Mehara功能评价:优13例,良2例,可1例;优良率为93.8%.结论切开复位内固定术是治疗陈旧性Barton骨折的一种积极而有效的方法.CT检查对Barton骨折的诊断、了解关节面的移位情况、确定手术复位及固定可靠程度有一定的临床意义.
목적 분석진구성Barton골절적원인,탐토기검사여처리방법.방법 대16례진구성Barton골절(장측골절11례,배측골절5례),통과x선편검사병결합CT검사학정골절적류형.관절면적이위정도화완관절탈위정도.11례장측골절채용장뇨측절구T형금속판고정,5례배측골절채용뇨골원단배외측절구유한내고정가외고정가고정.결과 술후수방시간위10～36개월,평균12.5개월.X선편현시골절전부유합,완관절면장경각위10°～15°,평균11.3°;척편각16°～25°,평균20°;뇨골축향무단축.안Mehara공능평개:우13례,량2례,가1례;우량솔위93.8%.결론 절개복위내고정술시치료진구성Barton골절적일충적겁이유효적방법.CT검사대Barton골절적진단、료해관절면적이위정황、학정수술복위급고정가고정도유일정적림상의의.
Objective To analyze the etiology of old Barton's fractures and discuss the diagnostis strategies and treatment options. Methods Sixteen cases of old Barton's fracture(11 cases of volar fractures and 5 cases of dorsal fractures) were involved.Plain X-ray examines were combined with CT scan to determine type of the fractures.displacement of ioint surfaces and the severity of wrist joint dislocation.Eleven cases of volar Barton's fractures were fixed with T-shaped metallic plate via a volar-radial approach.Five cases of dorsal Barton fractures were treated with limited intemal fixation combined with external fixator via a distal dorsolateral incision. Results All 16 patients were followed-up for 10 to 36 months postoperatively.Bone union was seen in all cases.The volar tilting angle was 10°～15°(average 11.3°).The ulnar inclining angle Was 16°～25°(average 20°).There was no shortening of the radius.According to Mehara's evaluation for volar Barton's fractures.15 cases(93.8%)had obtained sarisfying results(excellent in 13 cases.good in 2 cases,fare in 1 case). Conclusions Open reduction and intemal fixation is an effective method to treat old Barton's fractures.CT scan is helpful in revealing fracture details.displaying joint surface displacement,and judging the accuracy of surgical reduction and fixation.