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严重桡骨远端骨折的治疗
Hits: 2176   Download times: 1163   Received:December 21, 2005    
作者Author单位UnitE-Mail
吴有鲁 WU You-lu 杭州市余杭第二人民医院骨科,浙江杭州311121 Department of Orthopaedics,the 2nd People′s Hospital of Yuhang,Hangzhou 311121,Zhejiang,China hzyhwyc3518@163.com 
冯庆生 FENG Qing-sheng 杭州市余杭第二人民医院骨科,浙江杭州311121 Department of Orthopaedics,the 2nd People′s Hospital of Yuhang,Hangzhou 311121,Zhejiang,China  
丁彩田 DING Cai-tian 杭州市余杭第二人民医院骨科,浙江杭州311121 Department of Orthopaedics,the 2nd People′s Hospital of Yuhang,Hangzhou 311121,Zhejiang,China  
张勤中 ZHANG Qin-zhong 杭州市余杭第二人民医院骨科,浙江杭州311121 Department of Orthopaedics,the 2nd People′s Hospital of Yuhang,Hangzhou 311121,Zhejiang,China  
章武华 ZHANG Wu-hua 杭州市余杭第二人民医院骨科,浙江杭州311121 Department of Orthopaedics,the 2nd People′s Hospital of Yuhang,Hangzhou 311121,Zhejiang,China  
费爽明 FEI Shuang-ming 杭州市余杭第二人民医院骨科,浙江杭州311121 Department of Orthopaedics,the 2nd People′s Hospital of Yuhang,Hangzhou 311121,Zhejiang,China  
闻鑫高 WEN Xin-gao 杭州市余杭第二人民医院骨科,浙江杭州311121 Department of Orthopaedics,the 2nd People′s Hospital of Yuhang,Hangzhou 311121,Zhejiang,China  
林栋 LIN Dong 杭州市余杭第二人民医院骨科,浙江杭州311121 Department of Orthopaedics,the 2nd People′s Hospital of Yuhang,Hangzhou 311121,Zhejiang,China  
曹华 CAO Hua 杭州市余杭第二人民医院骨科,浙江杭州311121 Department of Orthopaedics,the 2nd People′s Hospital of Yuhang,Hangzhou 311121,Zhejiang,China  
何利江 HE Li-jiang 杭州市余杭第二人民医院骨科,浙江杭州311121 Department of Orthopaedics,the 2nd People′s Hospital of Yuhang,Hangzhou 311121,Zhejiang,China  
董海兵 DONG Hai-bing 杭州市余杭第二人民医院骨科,浙江杭州311121 Department of Orthopaedics,the 2nd People′s Hospital of Yuhang,Hangzhou 311121,Zhejiang,China  
期刊信息:《中国骨伤》2006年19卷,第10期,第593-594页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:探讨严重桡骨远端骨折治疗方法及临床疗效。

方法:47例桡骨远端骨折,男20例,女27例;年龄45~89岁,平均67岁。按AO原则分类,根据不同的骨折类型,采用不同的治疗方法。21例(A组)采用闭合复位石膏或夹板外固定,其中A31例,B12例,B23例,B33例,C112例。8例(B组)采用闭合整复,多功能支架外固定(包括配合经皮克氏针固定),A31例,B22例,C11例,C22例,C32例。6例(C组)采用切开复位T形或斜T形钢板螺钉内固定,其中B11例,B22例,C12例,C21例。12例(D组)切开复位钢板内固定配合多功能支架外固定,B12例,B22例,B33例,C13例,C21例,C31例。

结果:按Shea评定法评估,A组(非手术组)优8例,良6例,中5例,差2例,优良率为66.7%(14/21);B组优6例,良1例,中1例,优良率87.5%(7/8);C组优4例,良1例,中1例;D组优8例,良2例,中2例,C、D两组优良率均为83.3%(5/6,10/12)。

结论:严重桡骨远端骨折,根据AO分类的不同,手术治疗比非手术治疗有明显的优势,具体方法可根据骨折的类型不同进行选择。
[关键词]:严重的桡骨远端骨折  治疗方案
 
Treatment of severe distal radius fracture
Abstract:

Objective:To explore therapeutic method and clinical effect of severe distal radialis fracture.

Methods:Forty-seven distal radial fractures(20 males and 27 females,aged from 45 to 89 years with an average of 67 years)were treated with different methods according to different classification of fracture.Among the patients,21 cases underwent close reduction and splinting(group A;A3,B1,B2,B3,C1 were 1,2,3,3,12 respectively),8 cases underwent close reduction and multiple-power external fixation (group B;A3,B2,C1,C2,C3 were 1,2,1,2,2 respectively),6 cases underwent open reduction and T-shape steel plate fixation (group C;B1,B2,C1,C2 were 1,2,2,1 respectively),12 cases undenwent open reduction and multiple-power external fixation(group D;B1,B2,B3,C1,C2,C3 were 2,2,3,3,1,1 respectively).

Results:According to the criterion of Shea, 8 cases obtained excellent result,6 good,5 fair,2 poor,the rate of excellent and good was 66.7% (14/21) in group A.Six cases obtained excellent result,1 good,1 fair,the rate of excellent and good was 87.5% (7/8) in group B.In group C and D,the excellent,good,fair result were,4,1,1 and 8,2,2 respectively,the rate of excellent and good was 83.3%(5/6,10/12).

Conclusion:Operative treatmemt for severe distal radial fracture has the advantage over non-operative.Operative methods can be selected according to fracture type.
KEYWORDS:Severe distal radialis fracture  Treatment protocols
 
引用本文,请按以下格式著录参考文献:
中文格式:吴有鲁,冯庆生,丁彩田,张勤中,章武华,费爽明,闻鑫高,林栋,曹华,何利江,董海兵.严重桡骨远端骨折的治疗[J].中国骨伤,2006,19(10):593~594
英文格式:WU You-lu,FENG Qing-sheng,DING Cai-tian,ZHANG Qin-zhong,ZHANG Wu-hua,FEI Shuang-ming,WEN Xin-gao,LIN Dong,CAO Hua,HE Li-jiang,DONG Hai-bing.Treatment of severe distal radius fracture[J].zhongguo gu shang / China J Orthop Trauma ,2006,19(10):593~594
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