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桡骨远端骨折术后短缩的原因及对策
Hits: 2672   Download times: 1885   Received:February 25, 2010    
作者Author单位UnitE-Mail
杨德福 YANG De-fu 大丰同仁骨科医院, 江苏 大丰 224100 The Tongren Orthopaedic Hospital of Dafeng City,Dafeng 224100,Jiangsu,China ydfu73@sohu.com 
张功林 ZHANG Gong-lin 兰州军区总医院骨科研究所  
夏丽平 XIA Li-ping 大丰同仁骨科医院, 江苏 大丰 224100 The Tongren Orthopaedic Hospital of Dafeng City,Dafeng 224100,Jiangsu,China  
郁辉 YU Hui 大丰同仁骨科医院, 江苏 大丰 224100 The Tongren Orthopaedic Hospital of Dafeng City,Dafeng 224100,Jiangsu,China  
黄建华 HUANG Jian-hua 大丰同仁骨科医院, 江苏 大丰 224100 The Tongren Orthopaedic Hospital of Dafeng City,Dafeng 224100,Jiangsu,China  
陈建峰 CHEN Jian-feng 大丰同仁骨科医院, 江苏 大丰 224100 The Tongren Orthopaedic Hospital of Dafeng City,Dafeng 224100,Jiangsu,China  
期刊信息:《中国骨伤》2010年23卷,第8期,第581-584页
DOI:10.3969/j.issn.1003-0034.2010.08.007


目的:分析桡骨远端骨折术后出现短缩的原因,提出预防措施,提高桡骨远端骨折手术的复位效果及远期疗效。

方法:2005年6月至2009年1月,治疗桡骨远端骨折并获随访46例患者,男17例,女29例;年龄27~90岁,平均48岁。获得解剖复位或基本达解剖复位,对术后出现桡骨短缩的现象进行分析。

结果:46例获得随访,时间6个月~2年,平均14个月,有12例发生桡骨短缩。总结桡骨远端骨折术后短缩的原因:①年龄大于60岁;②重度骨质疏松;③移位大、粉碎性骨折;④固定方式选择不恰当;⑤植骨不充分;⑥过早负荷。

结论:术前正确判断骨折类型及骨的质量、充分植骨、解剖复位后牢固固定及早期非负荷功能锻炼是减少桡骨骨折术后短缩、提高桡骨远端骨折疗效的关键。在桡骨远端骨折手术及术后康复锻炼中,如能充分考虑上述6种造成桡骨短缩的原因并加以克服,将可能避免或延缓创伤性关节炎的发生。
[关键词]:桡骨骨折  手术后并发症  骨移植  外科手术  骨折固定术
 
The causes and strategies for the postoperative shortening in distal radius fractures
Abstract:

Objective: To analyze the cause of the postoperative shortening in distal radius fractures and to find treatment strategies to enhance the reduction effect of distal radius fracture and long-term efficacy.

Methods: From June 2005 to January 2009,46 patients with distal radius fractures were treated by surgical operation including 17 males and 29 females,ranging from 27 to 90 years old with an average age of 48 years. All fractures were reduced satisfactory with smooth articular surface.The postoperative radial shortening was analyzed.

Results: All patients were followed-up for 6 to 24 months with an average of 14 months. Among them,12 patients had radial shortening. The causes of postoperative radial shortening includes:①patients older than 60 years;②severe osteoporosis;③preoperative displacement and comminuted fractures;④inappropriate fixation methods;⑤inadequate bone graft;⑥premature load.

Conclusion: The key points to enhance the treatment outcomes include precise judgement of the fracture type and bone quality,sufficient bone graft,firmly fixed after anatomical reduction and an appropriate plan for early loadless functional exercise. Traumatic arthritis may be avoided or delayed if the above-mentioned six causes can be taken into consideration or preventive measures can be taken.
KEYWORDS:Radius fractures  Postoperative complications  Bone transplantation  Surgical procedures,operative  Fracture fixation
 
引用本文,请按以下格式著录参考文献:
中文格式:杨德福,张功林,夏丽平,郁辉,黄建华,陈建峰.桡骨远端骨折术后短缩的原因及对策[J].中国骨伤,2010,23(8):581~584
英文格式:YANG De-fu,ZHANG Gong-lin,XIA Li-ping,YU Hui,HUANG Jian-hua,CHEN Jian-feng.The causes and strategies for the postoperative shortening in distal radius fractures[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(8):581~584
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