[1]郑立程,季滢瑶,赵政.外固定支架结合Kapandji技术治疗老年桡骨远端不稳定性骨折[J].中医正骨,2020,32(03):67-69.
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外固定支架结合Kapandji技术治疗老年桡骨远端不稳定性骨折()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期数:
2020年03期
页码:
67-69
栏目:
临床报道
出版日期:
2020-03-20

文章信息/Info

作者:
郑立程季滢瑶赵政
(乐清市人民医院,浙江 乐清 325600)
关键词:
桡骨骨折 老年人 骨折固定术 外固定器 克氏针
摘要:
目的:探讨外固定支架结合Kapandji技术治疗老年桡骨远端不稳定性骨折的临床疗效和安全性。方法:2012年5月至2016年2月,采用外固定支架结合Kapandji技术治疗老年桡骨远端不稳定性骨折患者21例。男8例,女13例; 年龄60~78岁,中位数69岁; 均为闭合性骨折; 左侧8例,右侧13例。骨折AO分型为A3型6例、B2型3例、C2型9例、C3型3例。受伤至手术时间4 h至13 d,中位数5 d。术中牵拉患肢复位骨折块后,采用Kapandji技术用克氏针经皮插入骨折端维持骨折复位,然后安装外固定支架进行外固定。随访观察骨折复位、愈合及腕关节功能恢复和并发症发生情况。结果:21例患者均获随访,随访时间8~24个月,中位数15个月; 骨折均愈合,愈合时间6~13周,中位数8周。术后6个月时,患肢掌倾角7.1°~16.7°(中位数11.2°),尺偏角15.5°~25.3°(中位数20.4°),桡骨短缩均≤2 mm,关节面台阶均≤2 mm; 骨折复位影像学评分(0.48±0.02)分,优17例、良4例。末次随访时,腕关节Gartland-Werley评分(3.52±0.26)分,优13例、良5例、可3例。术后并发针道感染1例,拔除克氏针、积极抗炎治疗后感染控制; 并发桡神经浅支支配区感觉障碍1例,经对症处理后感觉恢复。均无断针、骨折不愈合及正中神经损伤、肌腱损伤等并发症发生。结论:外固定支架结合Kapandji技术治疗老年桡骨远端不稳定性骨折,操作简单、固定可靠、骨折复位和愈合好,有利于腕关节功能的恢复,且并发症少。

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备注/Memo

备注/Memo:
(收稿日期:2019-09-18 本文编辑:杨雅)
更新日期/Last Update: 2020-03-10