| 桡骨远端B型骨折 |
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投稿时间：2016-03-06
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| 作者 | Author | 单位 | Address | E-Mail |
| 程亚博 |
CHENG Ya-bo |
四川省骨科医院手腕科, 四川 成都 610041 |
Department of Orthopaedics Trauma and Hand Surgery, Orthopaedics Hospital of Sichuan Province, Chengdu 610041, Sichuan, China |
282394857@qq.com |
| 杨顺 |
YANG Shun |
四川省骨科医院手腕科, 四川 成都 610041 |
Department of Orthopaedics Trauma and Hand Surgery, Orthopaedics Hospital of Sichuan Province, Chengdu 610041, Sichuan, China |
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| 期刊信息：《中国骨伤》2016年，第29卷，第9期，第859-862页 |
| DOI：10.3969/j.issn.1003-0034.2016.09.017 |
| 基金项目: |
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中文摘要:
目的：探讨桡骨远端B型骨折腕关节镜直视下复位后予Herbert螺钉固定治疗的临床疗效。
方法：2013年6月至2015年7月，采用腕关节镜直视下手法复位及撬拨复位Herbert螺钉固定同时修复关节内软组织损伤的方法治疗桡骨远端患者28例，男15例，女13例；年龄17～69岁，平均45.3岁；病程为伤后4～7d。受伤后患者具有典型桡骨远端骨折体征，X线片及CT明确诊断，并确定不合并其余部位骨折及神经血管损伤，不合并严重内科疾病，无手术禁忌证。按AO/OTA分型：B1型8例，B2型7例，B3型13例。随访观察骨折愈合情况及腕关节功能恢复情况，并评定疗效。
结果：全部患者无手术并发症发生，28例桡骨远端B型骨折术后均获随访，平均随访时间（12.1±1.4）个月，骨折全部愈合，测量掌倾角（15.2±3.4）°，尺偏角（20.4±6.4）°。根据Cooney腕关节评分量表评估疗效，优21例，良5例，可2例。术中关节镜检合并舟月韧带撕裂3例，合并月三角韧带撕裂1例，合并TFCC损伤16例。
结论：腕关节镜辅助下复位Herbert螺钉固定治疗桡骨远端B型骨折可使关节面平整度最大程度恢复，应用Herbert螺钉固定创伤小，术后恢复时间短，减少骨折后创伤性关节炎的发病，同时可对骨折合并关节内韧带及软骨损伤一并修复恢复关节稳定性，降低腕关节慢性疼痛的发生率。 |
| 【关键词】桡骨骨折 腕关节 关节镜 |
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| Wrist arthroscopy assisted reduction and Herbert screw fixation for the treatment of type B distal radius fractures |
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ABSTRACT
Objective: To explore the clinical efficacy of internal fixation with arthroscope assistance in type B fractures of distal radius.
Methods: From June 2013 to July 2015,28 cases of type B distal radius fracture patients were enrolled into the study, including 15 males and 13 females with an average age of 45.3 years old ranging from 17 to 69 years old. These patients were treated with manipulative and poking reduction wrist arthroscopy,internal fixation with Herbert screws and repair of articular soft tissue,and the course of disease was 4 to 7 days after injury. Injured patients had the typical signs of distal radius fracture with confirming of X-ray and CT-imaging. Finally,no other fractures,no neurovascular injury,no other severe diseases and no surgical cortraindications were identified. According to the classification of AO/OTA,there were 8 cases of type B1,7 cases of type B2,13 cases of type B3. Patients were followed up for fracture healing,wrist joint function recovery,and curative effect.
Results: The 28 cases of type B distal radius fractures were followed up with an average of(12.1±1.4) months,all fractures were healed,palmer tilt angle was(15.2±3.4)°,ulnar drift angles was(20.4±6.4)°. Wrist functions were evaluated according to Cooney system and rated as excellent in 21 cases,good in 5 cases and fair in 2 cases. Intraoperative arthroscopy showed the tear of scapholunate ligaments in 3 cases,tear of in lunotriguetal ligaments in 1 case,and TFCC tear in 16 cases.
Conclusion: Wrist arthroscopy assisted treatment of distal radius fracture type B can make the recovery of joint surface roughness to a great extent. The application of Herbert screw brings in the small trauma,and the postoperative recovery time is short,reducing the incidence of traumatic arthritis and preventing the chronic pain or inastbility of the wrist in the future. |
| KEY WORDS Radius fractures Wrist joint Arthroscopes |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 程亚博,杨顺.桡骨远端B型骨折[J].中国骨伤,2016,29(9):859~862 |
| 英文格式: | CHENG Ya-bo,YANG Shun.Wrist arthroscopy assisted reduction and Herbert screw fixation for the treatment of type B distal radius fractures[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(9):859~862 |
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