摘要
目的 探讨闭合复位穿针内固定治疗高龄桡骨远端骨折的疗效。方法 采用闭合复位穿针内固定治疗21例高龄桡骨远端骨折患者。记录骨折愈合情况和并发症发生情况,测量桡骨远端的掌倾角、尺倾角、桡骨茎突高度,采用Cooney评分评估腕关节功能,比较患侧与健侧腕关节屈伸及前臂旋转度数。结果 患者均获得随访,时间12~15个月。骨折愈合时间9~11(9.84±0.57)周。3例出现克氏针松动,经对症处理后痊愈。掌倾角、尺倾角、桡骨茎突高度末次随访与术后即刻比较差异均无统计学意义(P> 0.05)。末次随访时,Cooney评分60~92(82.57±8.09)分,其中优5例,良12例,可3例,差1例,优良率17/21;腕关节及前臂的活动度患侧与健侧比较差异均有统计学意义(P<0.05),但能满足高龄患者对功能的要求。结论 闭合复位穿针内固定治疗高龄桡骨远端骨折操作简单,疗效确切。
Objective To investigate the effect of closed reduction and percutaneous Kirschner wire internal fixation for treatment of distal radius fractures in the senile patients.Methods The 21 senile patients with distal radius fracture were treated with closed reduction and percutaneous Kirschner wire internal fixation. Fracture healing and complications were recorded. Palmar inclination,ulnar inclination and radial styloid height of the distal radius were measured,wrist joint function was evaluated by Cooney score,the ranges of wrist joint flexion-extension and forearm rotation were compared between the affected side and healthy side.Results All patients were followed up for 12 ~ 15months. The healing time of fracture was 9 ~ 11(9. 84 ± 0. 57) weeks. Three cases had Kirschner wire loosening,and recovered after symptomatic treatment. There were no significant differences in palmar inclination,ulnar inclination and radial styloid height between last follow-up and immediately postoperation(P> 0. 05). At the last follow-up,the Cooney scores were 60 ~ 92(82. 57 ± 8. 09) points,of which 5 cases were excellent,12 cases were good,3 cases fair and 1 case poor,the excellent-good rate was 17/21. There were statistically significant differences in activity ranges of the wrist joint and forearm between the affected side and healthy side(P< 0. 05),while it could meet the functional requirements of senile patients.Conclusions It is simple and effective to treat senile distal radius fracture with closed reduction and percutaneous Kirschner wire internal fixation.
作者
杨克忠
王式鲁
徐宏浩
谢文鹏
毕荣修
YANG Ke-zhong;WANG Shi-lu;XU Hong-hao;XIE Wen-peng;BI Rong-xiu(The First Clinical School of Medicine,Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250014,China;Dept of Traumatic Orthopaedics,the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250014,China)
出处
《临床骨科杂志》
2022年第5期697-701,共5页
Journal of Clinical Orthopaedics
基金
山东省中医药管理局中医药科技发展计划项目(编号:2019-0152)。
关键词
桡骨远端骨折
闭合复位
穿针内固定
高龄
distal radial fractures
closed reduction
percutaneous Kirschner wire internal fixation
the senile
