腕关节镜辅助治疗桡骨远端Die-punch骨折
摘要点击次数: 9   全文下载次数: 0   投稿时间:2019-01-02  修订日期:2019-06-21  
作者Author单位AddressE-Mail
杨顺 yang shun 四川省骨科医院 Sichuan orthopedics hospital 710947364@qq.com 
向往* xiangwang 四川省骨科医院  
期刊信息:《中国骨伤》年,第卷,第期,第-页
DOI:
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中文摘要:目的 针对桡骨远端Die-punc骨折患者,采用腕关节镜辅助下切开复位治疗,评价治疗并分析效果,以此为临床提供相应的参考,提高诊治水平。方法 回顾性分析2015年12月-2017年5月我院骨科收治的50例确诊为桡骨远端 Die-punch骨折患者临床资料,其中男31例,女19例;年龄20-45岁,平均(34.12±2.56)岁。全部患者均采用腕关节镜辅助下经掌侧入路切开复位掌侧钢板内固定手术,对治疗的效果进行分析,比较治疗前后腕关节各部位(背伸、掌曲、尺偏、桡偏、旋前、旋后)活动范围以及腕关节功能(疼痛、功能状况、活动度、背伸/掌屈活动度、握力)。结果 50例患者均获得随访,为期18个月。DR断层扫描显示骨折全部愈合,桡骨轴向无短缩。发生3例切口感染,经处理全部消失,未发生其它严重并发症。根据Cooney腕关节功能评分表评价优良率为94.00%(46/50)。在背伸、掌曲、尺偏、桡偏、旋前、旋后等腕关节活动范围方面,术后18个月明显大于术前,差异有统计学意义(P<0.05)。在疼痛、功能状况、活动度、背伸/掌屈活动度、握力等腕关节功能方面,术后18个月均高于术前,差异有统计学意义(P<0.05)。结论 腕关节镜辅助下切开复位治疗桡骨远端 Die-punch 骨折能较好的恢复关节面的平整,有利于快速促进腕关节功能恢复,安全性较高,值得推广。
【关键词】腕关节镜  Die-punch 骨折  功能  效果
 
Arthroscopy-assisted treatment of distal radial die-punch fractures
ABSTRACT  Objective For patients with die-punc fractures of the distal radius, open reduction therapy assisted by wrist arthroscopy was adopted to evaluate the treatment and analyze the effect, so as to provide corresponding reference for clinical practice and improve the level of diagnosis and treatment. Methods Clinical data of 50 patients diagnosed as distal radial die-punch fractures admitted to our hospital from December 2015 to May 2017 were retrospectively analyzed, including 31 males and 19 females. Age range: 20-45 years old, mean (34.12 2.56) years old. All patients adopt wrist arthroscopy assisted by the volar approach open reduction surgery, volar plate fixation to analyze the effects of the treatment, compared before and after the treatment of each part of the wrist joint (the back stretch, palm, feet wide, radial deviation, pronation and supination) range and function of wrist joint (pain, functional status, activity, grip strength, back stretch/palm flexion mobility). Results All 50 patients were followed up for 18 months. DR tomography showed that all fractures healed without shortening of radial axis. Wound infection occurred in 3 cases, all of them disappeared after treatment, and no other serious complications occurred. According to Cooney wrist function scale, the excellent and good rate was 94.00% (46/50). In terms of wrist range of motion, such as dorsiflexion, palmar flexion, ulnar deviation, radial deviation, pronation, and pronation, the postoperative 18 months was significantly greater than that before and after the surgery, with statistically significant differences (P<0.05). In terms of pain, functional status, range of motion, range of dorsiflexion/palmar flexion, handgrip strength and other wrist joint functions, the postoperative 18 months were all higher than that before the operation, and the difference was statistically significant (P<0.05).Conclusion Carpal arthroscope-assisted open reduction for the treatment of die-punch fractures of the distal radius can better restore the formation of the articular surface, which is conducive to the rapid recovery of the function of the wrist, with high safety and is worth promoting.
KEY WORDS  Wrist arthroscopy  Die-punch fracture  Function  Effect
 
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