胡君春,Junchun Hu,吴国梅,Guomei Wu

目的：探讨临床手法复位经皮固定治疗尺桡骨远端骨折伴下尺桡关节分离的方法及疗效。方法：利用C臂X机透视，采用中医正骨手法复位，结合经皮克氏针固定及石膏外固定治疗尺桡骨远端骨折伴下尺桡关节分离[1]61例。结果：临床愈合时间4-8周，平均5周。随访3~12个月，骨折全部愈合，针孔感染3例，无畸形愈合，术后松动移位2例。按照临床功能评定标准，本组优54例，良7例，优良率为100％。结论：手法复位经皮固定治疗尺桡骨远端骨折伴下尺桡关节分离，创伤小，恢复快，并发症少，方法操作简单，适合临床开展运用。 Objective: To explore the method and curative effect of manual reduction and percutaneous fixation for distal ulnar and radial fractures with lower ulnar and radial joint separation.Methods:61 cases of distal ulnar and radial fractures with separation of lower ulnar and radial joints were treated with C-arm X-ray fluoroscopy, traditional Chinese medicine bone-setting reduction, percutaneous Kirschner wire fixation and plaster external fixation.Results: The clinical healing time was 4-8 weeks (average 5 weeks).Follow-up for 3~12 months showed that all fractures healed, pinhole infection was found in 3 cases, no malunion was found, and loosening and displacement were found in 2 cases.According to the standard of clinical function evaluation,54 cases were excellent and 7 good, the excellent and good rate was 100%.Conclusion: Manual reduction and percutaneous fixation for distal ulnar and radial fractures with separation of the lower ulnar and radial joints is a simple and suitable method for clinical application.

尺桡骨远端骨折；克氏针 Distal fracture of ulna and radius; Kirschner wire

[1] 胡祖愉,冯健,周海平,王文跃,陈顺方.桡骨远端骨折对下尺桡关节稳定性的影响[J].中国骨伤,2007(12). [2] 谢健,袁惠霞.手法整复桡骨远端骨折[J].临床骨科,2018(02). [3] 苏源冰,周泉腾,张细祥.手法复位加经皮穿针固定治疗桡骨远端骨折方法探讨[C]//中国中西医结合学会全国实验医学学术研讨会.2004. [4] 李唯,郑一舟,毛文,杨军,张明焕,祁福.外固定架及横向克氏针固定治疗下尺桡关节失稳桡骨远端骨折疗效分析[J].中国骨与关节损伤,2016(05). [5] 周明昌.老年性桡骨远端骨折夹板固定移位危险因素研究[D].广州中医药大学,2011.

点击下载PDF