标题：外固定支架治疗高龄桡骨远端粉碎性骨折的疗效分析

      作者：杨辉 1，许海甲 2，操儒道 1，范文科 1，梅广涛 1，袁丁 1，李章华 2
    (1.钟祥市人民医院骨二科，湖北 钟祥 431900；
2.武汉市第三医院光谷院区骨二科，湖北 武汉 430074)

      卷次： 2016年27卷19期

      【摘要】 目的 观察外固定支架治疗高龄桡骨远端粉碎性骨折患者的疗效。方法 回顾性分析2013年9月
至2016年3月我院收治的70岁以上采用外固定支架治疗的桡骨远端粉碎性骨折患者47例(48侧)，随访6~18个月，
术后4个月评价影像学骨折愈合结果，术后6个月评价患肢腕关节功能。结果 术后2~4个月46例(47侧)患者骨
折一期愈合，1例(1侧)患者延迟愈合；患者平均掌倾角12.3°、尺偏角22°、桡骨高度10.3 mm；影像学结果Lidstrom分
级显示：Ⅰ级16例16侧，Ⅱ级19例20侧，Ⅲ级9例9侧，Ⅳ级3例3侧；术后6个月患侧腕关节功能PRWE评分结果
显示：优18例19侧，良20例20侧，可6例6侧，差3例3侧，优良率为81.25%；共有6例7侧患者发生钉道感染，2例2
侧发生克氏针退针，1例1侧桡骨钉孔处骨折。结论 外固定支架治疗高龄桡骨远端粉碎性骨折患者优良率高，并
发症少，是一种可靠的治疗方法。

      【关键词】 高龄患者；桡骨远端粉碎性骨折；外固定支架固定；疗效

      【中图分类号】 R683.41 【文献标识码】 A 【文章编号】 1003—6350（2016）19—3225—03


Efficacy of external fixation in the treatment of elderly patients with distal radius comminuted fractures.
YANG
Hui 1, XU Hai-jia 2, CAO Ru-dao 1, FAN Wen-ke 1, MEI Guang-tao 1, YUAN Ding 1, LI Zhang-hua 2. 1. The Sencond
Department of Orthopaedics, Zhongxiang People's Hospital, Zhongxiang 431900, Hubei, CHINA; 2. The Sencond
Department of Orthopaedics, Guanggu Branch of Wuhan Third Hospital, Wuhan 430074, Hubei, CHINA

【Abstract】 Objective To discuss the effect of external fixation in the treatment of elderly patients with dis-
tal radius comminuted fractures. Methods The clinical data of 48 sides of 47 patients who aged over 70 years with
distal radius comminuted fractures treated by external fixation in our hospital from September 2013 to March 2016
were retrospectively reviewed. The patients were followed up for 6~18 months. Four months after operation, fracture
healing result was evaluated by X-ray. Six months after operation, limb wrist function was evaluated by PREW score.
Results Fouty-seven sides of 46 patients were healed by first intention during 2~4 months after operation, and 1 side of
1 patient had delayed healing. The patients' palm dip, radial inclination and radius height were respectively 12.3°, 22°
and 10.3 mm in average. Imaging results of Lidstrom grading showed that there were 16 sides of 16 patients of gradeⅠ,
20 sides of 19 patients of grade Ⅱ, 9 sides of 9 patients of grade Ⅲ, 3 sides of 3 patients of grade Ⅳ. Six months after
surgery, the wrist function of PRWE score were excellent in 19 sides of 18 patients, good in 20 sides of 20 patients, fair
in 6 sides of 6 patients, poor in 3 sides of 3 patients, with the excellent rate was 81.25%. Seven sides of 6 patients had
pin tract infection, 2 side of 2 patients' had Kirschner needle retraction, and 1 side of 1 patient was occurred radius frac-
ture on the pin tract. Conclusion External fixation in the treatment of elderly patients with distal radius comminuted
fractures has high excellent and good postoperative complications, which is a reliable treatment method.

      【Key words】 Elderly patients; Distal radius comminuted fractures; External fixation; Efficacy
·临床经验·doi:10.3969/j.issn.1003-6350.2016.19.045