中华手外科杂志
中華手外科雜誌
중화수외과잡지
CHINESE JOURNAL OF HAND SURGERY
2011年
6期
351-353
,共3页
简小飞%蒋林%张施展%周忠
簡小飛%蔣林%張施展%週忠
간소비%장림%장시전%주충
桡骨骨折%骨折固定术%外固定器%组合克氏针
橈骨骨摺%骨摺固定術%外固定器%組閤剋氏針
뇨골골절%골절고정술%외고정기%조합극씨침
Radius fractures%Fracture fixation%External fixators%Combined Kirschner wire
目的 探讨外固定架结合组合克氏针技术治疗不稳定性桡骨远端关节内骨折的方法及效果.方法 对46例不稳定桡骨远端关节内骨折患者,采用外固定架结合组合克氏针技术进行治疗.按AO/ ASIF分型:C1型27例,C2型16例,C3型3例.根据改良的Sarmiento评分,从掌倾角、尺偏角、桡骨短缩和关节面台阶方面对桡骨远端影像学进行评估；采用Gartland-Werley功能评分标准对腕关节功能进行评估,对结果进行统计学分析.结果 所有患者均获得10～ 42个月的随访,平均25个月.掌倾角由术前(- 18.5±10.2)°改善至术后(8.7±3.8)°,尺偏角由术前(- 14.6±4.5)°改善至术后(17.5±6.1)°,桡骨短缩由术前(6.0±2.1)mm改善至术后(0.7±0.3)mm,关节面塌陷由术前(5.3±3.6)mm改善至术后(0.8±0.2)mm.按Sarmiento评分标准评定:优31例,良15例；按GartlandWerley功能评分标准评定:优19例,良23例,可4例.结论 外固定架结合组合克氏针技术是治疗不稳定性桡骨远端关节内骨折的一种有效方法,复位固定可靠,手术创伤小,可减少复位丢失.
目的 探討外固定架結閤組閤剋氏針技術治療不穩定性橈骨遠耑關節內骨摺的方法及效果.方法 對46例不穩定橈骨遠耑關節內骨摺患者,採用外固定架結閤組閤剋氏針技術進行治療.按AO/ ASIF分型:C1型27例,C2型16例,C3型3例.根據改良的Sarmiento評分,從掌傾角、呎偏角、橈骨短縮和關節麵檯階方麵對橈骨遠耑影像學進行評估；採用Gartland-Werley功能評分標準對腕關節功能進行評估,對結果進行統計學分析.結果 所有患者均穫得10～ 42箇月的隨訪,平均25箇月.掌傾角由術前(- 18.5±10.2)°改善至術後(8.7±3.8)°,呎偏角由術前(- 14.6±4.5)°改善至術後(17.5±6.1)°,橈骨短縮由術前(6.0±2.1)mm改善至術後(0.7±0.3)mm,關節麵塌陷由術前(5.3±3.6)mm改善至術後(0.8±0.2)mm.按Sarmiento評分標準評定:優31例,良15例；按GartlandWerley功能評分標準評定:優19例,良23例,可4例.結論 外固定架結閤組閤剋氏針技術是治療不穩定性橈骨遠耑關節內骨摺的一種有效方法,複位固定可靠,手術創傷小,可減少複位丟失.
목적 탐토외고정가결합조합극씨침기술치료불은정성뇨골원단관절내골절적방법급효과.방법 대46례불은정뇨골원단관절내골절환자,채용외고정가결합조합극씨침기술진행치료.안AO/ ASIF분형:C1형27례,C2형16례,C3형3례.근거개량적Sarmiento평분,종장경각、척편각、뇨골단축화관절면태계방면대뇨골원단영상학진행평고；채용Gartland-Werley공능평분표준대완관절공능진행평고,대결과진행통계학분석.결과 소유환자균획득10～ 42개월적수방,평균25개월.장경각유술전(- 18.5±10.2)°개선지술후(8.7±3.8)°,척편각유술전(- 14.6±4.5)°개선지술후(17.5±6.1)°,뇨골단축유술전(6.0±2.1)mm개선지술후(0.7±0.3)mm,관절면탑함유술전(5.3±3.6)mm개선지술후(0.8±0.2)mm.안Sarmiento평분표준평정:우31례,량15례；안GartlandWerley공능평분표준평정:우19례,량23례,가4례.결론 외고정가결합조합극씨침기술시치료불은정성뇨골원단관절내골절적일충유효방법,복위고정가고,수술창상소,가감소복위주실.
Objective To explore the method and evaluate the effect of external fixator associated with combined Kirschner wire technique for the treatment of instable intra-articular distal radial fractures.Methods Forty-six patients with instable intra-articular distal radial fractures were treated with external fixator combined with Kirschner wire technique.According to AO/ASIF classification,there were 27 cases of type C1 fractures,16 cases of type C2 fractures and 3 cases of type C3 fractures.The radiographic parameters were evaluated according to modified Sarmiento scale regarding the volar tilt,radial inclination,radial shortening and stepping of the articular surface.Wrist function was assessed using Gartland-Werley scoring system.The results were statistically analyzed.Results All patients were successfully follow-up for 10 to 42 months with an average of 25 months.The volar tiit increased from ( - 18.5 ± 10.2)° to (8.7 ± 3.8)°,radial inc inclination increased from ( - 14.6±4.5)° to (17.5±6.1)°,radial shortening decreased from (6.0± 2.1)mm to (0.7 ± 0.3)mm and articular surface stepping decreased from (5.3 ± 3.6 )mm to (0.8 ± 0.2 ) mm.The radiographic manifestation was rated as excellent in 31 patients and good in 15 according to the Sarmiento scale.Garland-Werley functional assessment rated wrist function to be excellent in 19 patients,good in 23 and fair in 4.Conclusion External fixator associated with combined Kirschner wire technique is an effective method for treatment of dorsal instable intra-articular distal radial fractures,which can provide successful reduction and reliable fixation.It causes less operative trauma and reduces reduction loss.
