腕关节镜辅助下联合切开复位腕掌侧韧带骨性重建固定治疗桡骨远端Fernandez Ⅳ型骨折
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作者Author单位AddressE-Mail
程亚博 CHENG Ya-bo 四川省骨科医院, 四川 成都 610041 Sichuan Province Orthopaedics Hospital, Chengdu 610041, Sichuan, China 282394857@qq.com 
杨顺 YANG Shun 四川省骨科医院, 四川 成都 610041 Sichuan Province Orthopaedics Hospital, Chengdu 610041, Sichuan, China  
期刊信息:《中国骨伤》2022年,第35卷,第6期,第566-571页
DOI:10.12200/j.issn.1003-0034.2022.06.012
基金项目:
中文摘要:

目的:探讨腕关节镜辅助下联合切开复位腕掌侧韧带骨性重建固定治疗桡骨远端Fernandez Ⅳ型骨折的临床疗效。

方法:自2018年1月至2019年12月,采用腕关节镜辅助下联合切开复位腕掌侧韧带骨性重建固定治疗11例桡骨远端Fernandez Ⅳ型骨折患者,男8例,女3例;年龄23~42岁;骨折按照Fernandez分型均为Ⅳ型。术后观察骨折愈合情况、腕关节活动度及腕关节功能恢复情况,术后12个月采用视觉模拟评分(visual analogue scale,VAS)评估患者腕部疼痛情况,并采用Cooney腕关节评分评估临床疗效。

结果:所有患者术后获得随访,时间12~13个月。骨折全部愈合,时间4~6个月。术后12个月VAS评分为0~3分。掌倾角0°~15°,尺偏角15°~21°,腕关节屈伸活动度110°~162°,前臂旋转活动度165°~178°。Cooney腕关节综合评分为70~95分,优8例,良2例,可1例。术后无骨关节炎发生及相应并发症发生。

结论:桡骨远端Fernandez Ⅳ型骨折,采用腕关节镜辅助下联合切开复位腕掌侧韧带骨性重建有效的复位固定治疗,术后给予康复指导系统功能恢复锻炼,临床效果满意。
【关键词】桡骨骨折|关节镜|骨折切开复位|骨重建
 
Wrist arthroscopy assisted open reduction and volar ligament reconstruction through osseous internal fixation for the treatment of distal radius Fernandez type Ⅳ fractures
ABSTRACT  

Objective: To explore clinical effect of treatment for distal radius Fernandez type Ⅳ fractures by wrist arthroscopy assisted open reduction and volar ligament reconstruction through osseous,internal fixation.

Methods: From January 2018 to December 2019,11 patients distal radius Fernandez type Ⅳ fractures treated with wrist arthroscopy assisted open reduction and volar ligament reconstruction through osseous,internal fixation,including 8 males and 3 females,aged from 23 to 42 years old. The fracture were all calssified to type Ⅳ according to Fernandez classification. Postoperative fracture healing,activity of wrist joint and recovery of wrist joint were observed,postoperative visual analogue scale(VAS) at 12 months was used to evaluate pain of wrist joint,and Cooney wrist score scale was used to evaluate clinical effects.

Results: All the 11 patients were followed up from 12 to 13 months,and fractures were healed well for 4 to 6 months. Postoperative VAS at 12 months ranged from 0 to 3,palm tilt angle ranged from 0° to 15 °,ulnar drift angle ranged from 15° to 21°,wrist flexion and extension motion ranged from 110° to 162°,forearm rotation motion ranged from 165° to 178°. Cooney wrist joint comprehensive score ranged from 70 to 95 points,and 8 patients got excellent result,2 good,and 1 fair. No osteoarthritis and complications occurred.

Conclusion: Wrist arthroscopy assisted open reduction and volar ligament reconstruction through osseous,internal fixation for the treatment of Fernandez Ⅳ distal radius fractures could recevie effective fixation,and could receive satisfied clinical effect with system function exercise postoperative.
KEY WORDS  Radius fractures|Arthroscopes|Open fracture reduction|Bone remodeling
 
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.腕关节镜辅助下联合切开复位腕掌侧韧带骨性重建固定治疗桡骨远端Fernandez Ⅳ型骨折[J].中国骨伤,2022,35(6):566~571
英文格式:CHENG Ya-bo,YANG Shun.Wrist arthroscopy assisted open reduction and volar ligament reconstruction through osseous internal fixation for the treatment of distal radius Fernandez type Ⅳ fractures[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(6):566~571
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