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老年桡骨远端骨折保守治疗的疗效分析
Hits: 3258   Download times: 1593   Received:May 18, 2006    
作者Author单位UnitE-Mail
刘印文 LIU Yin-wen 上海中医药大学附属曙光医院骨伤科,上海200021 Department of Orthopaedic and Traumatology,the Affiliated Shuguang Hospital of Shanghai University of TCM,Shanghai 200021,China yinwenliu@yahoo.com.cn 
汤荣光 TANG Rong-guang 上海中医药大学附属曙光医院骨伤科,上海200021 Department of Orthopaedic and Traumatology,the Affiliated Shuguang Hospital of Shanghai University of TCM,Shanghai 200021,China  
匡勇 KUANG Yong 上海中医药大学附属曙光医院骨伤科,上海200021 Department of Orthopaedic and Traumatology,the Affiliated Shuguang Hospital of Shanghai University of TCM,Shanghai 200021,China  
郑昱新 ZHENG Yu-xin 上海中医药大学附属曙光医院骨伤科,上海200021 Department of Orthopaedic and Traumatology,the Affiliated Shuguang Hospital of Shanghai University of TCM,Shanghai 200021,China  
俞仲翔 YU Zhong-xiang 上海中医药大学附属曙光医院骨伤科,上海200021 Department of Orthopaedic and Traumatology,the Affiliated Shuguang Hospital of Shanghai University of TCM,Shanghai 200021,China  
顾坚毅 GU Jian-yi 上海中医药大学附属曙光医院骨伤科,上海200021 Department of Orthopaedic and Traumatology,the Affiliated Shuguang Hospital of Shanghai University of TCM,Shanghai 200021,China  
王鹤歧 WANG He-qi 上海中医药大学附属曙光医院骨伤科,上海200021 Department of Orthopaedic and Traumatology,the Affiliated Shuguang Hospital of Shanghai University of TCM,Shanghai 200021,China  
周国林 ZHOU Guo-lin 上海中医药大学附属曙光医院骨伤科,上海200021 Department of Orthopaedic and Traumatology,the Affiliated Shuguang Hospital of Shanghai University of TCM,Shanghai 200021,China  
詹红生 ZHAN Hong-sheng 上海中医药大学附属曙光医院骨伤科,上海200021 Department of Orthopaedic and Traumatology,the Affiliated Shuguang Hospital of Shanghai University of TCM,Shanghai 200021,China  
石印玉 SHI Yin-yu 上海中医药大学附属曙光医院骨伤科,上海200021 Department of Orthopaedic and Traumatology,the Affiliated Shuguang Hospital of Shanghai University of TCM,Shanghai 200021,China  
期刊信息:《中国骨伤》2007年20卷,第2期,第85-87页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:上海市重点学科建设项目(编号:T0303)


目的:研究桡骨远端骨折原始移位程度与骨折愈合后骨折对位质量的关系。

方法:桡骨远端骨折患者41例,男5例,女36例;年龄50-82岁,平均67.8岁。按Lidstrom分型:Ⅰ型3例,Ⅱ型12例,Ⅲ型11例,Ⅳ型15例。按Frykman分型:Ⅰ型3例,Ⅱ型6例,Ⅲ型5例,Ⅳ型6例,Ⅴ型7型,Ⅵ型4例,Ⅶ型4例,Ⅷ型6例。粉碎性骨折20例。对愈合后的复位质量进行评估,并分别对LidstromⅠ-Ⅱ型和Ⅲ-Ⅳ型,FrykmanⅠ-Ⅳ型和Ⅴ-Ⅷ型,非粉碎性骨折和粉碎性骨折愈合后的复位质量进行了比较。

结果:41例患者随访6个月,按Dienst复位质量评分,优3例,良21例,优良率为58.5%(24/41)。LidstromⅠ-Ⅱ型和Ⅲ-Ⅳ型愈合后复位质量优良率分别为86.7%(13/15)和42.3%(11/26)(P<0.01);FrykmanⅠ-Ⅳ型和Ⅴ-Ⅷ型愈合后复位质量优良率分别为65.0%(13/20)和52.4%(11/21)(P<0.05);非粉碎性骨折和粉碎性骨折愈合后复位质量优良率分别为81.0%(17/21)和35.0%(7/20)(P<0.01)。

结论:原始移位大的、粉碎性的不稳定桡骨远端骨折,愈合后容易出现短缩和再移位,建议采用经皮穿针、外固定支架及开放复位内固定等方法恢复并维持桡骨远端的解剖对应关系。
[关键词]:桡骨远端骨折  复位质量  不稳定
 
Analysis of effect of conservative treatment on fracture of distal radius in the elderly patients
Abstract:

Objective: To study the relationship between dislocated degree and healing outcome in fracture of distal radius.

Methods: Forty-one patients with distal radius fracture,5 cases were male and 36 female with the average age of 67.8 years(ranging from 50 to 82).According to Lidstrom classification,type Ⅰto Ⅳ each had 3,12,11,15 cases respectively;According to Frykman typing,type Ⅰ to Ⅷ had 3,6,5,6,7,4,4,6 cases respectively.Twenty cases were comminuted fracture in the study.The healing condition of all the patients were evaluated and the effect of Lidstrom Ⅰ,Ⅱ and Lidstrom Ⅲ,Ⅳ,Frykman Ⅰ to Ⅳ and Frykman Ⅴ to Ⅷ,non-comminuted and comminuted fracture were compared.

Results: All the patients were followed up for 6 months.According to Dienst scoring system,3 cases obtained excellent result and 21 good,the excellent and good rate was 58.5%(24/41).The excellent and good rate were 86.7%(13/15),42.3%(11/26),65.0%(13/20),52.4%(11/21),81.0%(17/21),35.0%(7/20) respectively in LidstromⅠ,Ⅱand Lidstrom Ⅲ,Ⅳ(P<0.01),FrykmanⅠ to Ⅳand Frykman Ⅴ to Ⅷ(P>0.05),non-comminuted and comminuted fracture(P<0.01).

Conclusion: Unstable fracture of distal radius with more initial displacement and comminuted fracture are prone to shortening and re-displacement after healing.Using percutaneous pins fixation,external fixation and internal fixation after open reduction for above fracture can regain and keep anatomic relations.
 
引用本文,请按以下格式著录参考文献:
中文格式:刘印文,汤荣光,匡勇,郑昱新,俞仲翔,顾坚毅,王鹤歧,周国林,詹红生,石印玉.老年桡骨远端骨折保守治疗的疗效分析[J].中国骨伤,2007,20(2):85~87
英文格式:LIU Yin-wen,TANG Rong-guang,KUANG Yong,ZHENG Yu-xin,YU Zhong-xiang,GU Jian-yi,WANG He-qi,ZHOU Guo-lin,ZHAN Hong-sheng,SHI Yin-yu.Analysis of effect of conservative treatment on fracture of distal radius in the elderly patients[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(2):85~87
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