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[1]鄭立程,季瀅瑤,趙政.外固定支架結(jié)合Kapandji技術(shù)治療老年橈骨遠(yuǎn)端不穩(wěn)定性骨折[J].中醫(yī)正骨,2020,32(03):67-69.
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外固定支架結(jié)合Kapandji技術(shù)治療老年橈骨遠(yuǎn)端不穩(wěn)定性骨折()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年03期
頁(yè)碼:
67-69
欄目:
臨床報(bào)道
出版日期:
2020-03-20

文章信息/Info

作者:
鄭立程季瀅瑤趙政
(樂(lè)清市人民醫(yī)院,浙江 樂(lè)清 325600)
關(guān)鍵詞:
橈骨骨折 老年人 骨折固定術(shù) 外固定器 克氏針
摘要:
目的:探討外固定支架結(jié)合Kapandji技術(shù)治療老年橈骨遠(yuǎn)端不穩(wěn)定性骨折的臨床療效和安全性。方法:2012年5月至2016年2月,采用外固定支架結(jié)合Kapandji技術(shù)治療老年橈骨遠(yuǎn)端不穩(wěn)定性骨折患者21例。男8例,女13例; 年齡60~78歲,中位數(shù)69歲; 均為閉合性骨折; 左側(cè)8例,右側(cè)13例。骨折AO分型為A3型6例、B2型3例、C2型9例、C3型3例。受傷至手術(shù)時(shí)間4 h至13 d,中位數(shù)5 d。術(shù)中牽拉患肢復(fù)位骨折塊后,采用Kapandji技術(shù)用克氏針經(jīng)皮插入骨折端維持骨折復(fù)位,然后安裝外固定支架進(jìn)行外固定。隨訪觀察骨折復(fù)位、愈合及腕關(guān)節(jié)功能恢復(fù)和并發(fā)癥發(fā)生情況。結(jié)果:21例患者均獲隨訪,隨訪時(shí)間8~24個(gè)月,中位數(shù)15個(gè)月; 骨折均愈合,愈合時(shí)間6~13周,中位數(shù)8周。術(shù)后6個(gè)月時(shí),患肢掌傾角7.1°~16.7°(中位數(shù)11.2°),尺偏角15.5°~25.3°(中位數(shù)20.4°),橈骨短縮均≤2 mm,關(guān)節(jié)面臺(tái)階均≤2 mm; 骨折復(fù)位影像學(xué)評(píng)分(0.48±0.02)分,優(yōu)17例、良4例。末次隨訪時(shí),腕關(guān)節(jié)Gartland-Werley評(píng)分(3.52±0.26)分,優(yōu)13例、良5例、可3例。術(shù)后并發(fā)針道感染1例,拔除克氏針、積極抗炎治療后感染控制; 并發(fā)橈神經(jīng)淺支支配區(qū)感覺(jué)障礙1例,經(jīng)對(duì)癥處理后感覺(jué)恢復(fù)。均無(wú)斷針、骨折不愈合及正中神經(jīng)損傷、肌腱損傷等并發(fā)癥發(fā)生。結(jié)論:外固定支架結(jié)合Kapandji技術(shù)治療老年橈骨遠(yuǎn)端不穩(wěn)定性骨折,操作簡(jiǎn)單、固定可靠、骨折復(fù)位和愈合好,有利于腕關(guān)節(jié)功能的恢復(fù),且并發(fā)癥少。

參考文獻(xiàn)/References:

[1] 武慶生,黃阿勇,栗國(guó)強(qiáng).三步整復(fù)法小夾板外固定治療老年Colles骨折[J].中醫(yī)正骨,2018,30(3):76-77.
[2] LUKAS K,HELWIG P,SEIFERT J,et al.Internal fixation of dorsally comminuted fractures of the distal part of the radius:a biomechanical analysis of volar plate and intramedullary nail fracture stability[J].Arch Orthop Trauma Surg,2011,131(11):1529-1537.
[3] 劉欣,劉文剛,吳淮,等.3種方法治療C型橈骨遠(yuǎn)端骨折的對(duì)比研究[J].中醫(yī)正骨,2015,27(5):12-16.
[4] NETO A P,LHAMBY F C.Fixation of fractures of the distal extremity of the radius using the modified Kapandji technique:evaluation of the radiological results[J].Rev Bras Ortop,2015,46(4):368-373.
[5] 從慶武,劉磊,王沖,等.持續(xù)牽引下閉合復(fù)位克氏針內(nèi)固定治療橈骨遠(yuǎn)端骨折[J].中醫(yī)正骨,2017,29(11):74-75.
[6] KUMBARACI M,KUCUK L,KARAPINAR L,et al.Retrospective comparison of external fixation versus volar locking plate in the treatment of unstable intra-articular distal radius fractures[J].Eur J Orthop Surg Traumatol,2014,24(2):173-178.
[7] OMOKAWA S,ABE Y,IMATANI J,et al.Treatment of intra-articular distal radius fractures[J].Hand Clin,2017,33(3):529-543.
[8] 張英澤.臨床骨折分型[M].北京:人民衛(wèi)生出版社,2013:4.
[9] 張世民,李海豐,黃軼剛.骨折分類與功能評(píng)定[M].北京:人民軍醫(yī)出版社,2008:318.
[10] 蔣協(xié)遠(yuǎn),王大偉.骨科臨床療效評(píng)價(jià)標(biāo)準(zhǔn)[M].北京:人民衛(wèi)生出版社,2005:37-38.
[11] DONG W,LEI S,ZHOU J L.Locking plate versus external fixation for type C distal radius fractures:a meta-analysis of randomized controlled trials[J].Chin J Traumatol,2018,21(2):113-117.
[12] 付婷婷,張?chǎng)?馬曉東,等.腕關(guān)節(jié)損傷中醫(yī)康復(fù)治療方案的臨床療效觀察[J].中醫(yī)正骨,2018,30(12):55-57.
[13] BALES J G,STERN P J.Treatment strategies of distal radius fractures[J].Hand Clin,2012,28(2):177-184.
[14] KAWASAKI K,NEMOTO T,INAGAKI K,et al.Variable-angle locking plate with or without double-tiered subchondral support procedure in the treatment of intra-articular distal radius fracture[J].J Orthop Traumatol,2014,15(4):271-274.
[15] KHATRI K,SHARMA V,FAROOQUE K,et al.Surgical treatment of unstable distal radius fractures with a volar variable-angle locking plate:clinical and radiological outcomes[J].Arch Trauma Res,2016,5(2):e25174.
[16] 梁羽,何榮富,鐘鳳林.橈骨遠(yuǎn)端骨折治療失敗的原因分析[J].中醫(yī)正骨,2018,30(2):50-53.
[17] MULDERS M A,RIKLI D,GOSLINGS J C,et al.Classification and treatment of distal radius fractures:a survey among orthopaedic trauma surgeons and residents[J].Eur J Trauma Emerg Surg,2017,43(2):239-248.
[18] BARTL C,STENGEL D,BRUCKNER T,et al.The treatment of displaced intra-articular distal radius fractures in elderly patients[J].Dtsch Arztebl Int,2014,111(46):779-787.
[19] SIRIPAKARN Y,SUNTARAPA T,CHERNCHUJIT B.Multipurpose external fixation for unstable comminuted intraarticular fracture of distal radius[J].J Med Assoc Thai,2013,96(4):446-455.
[20] 吳官保,董克芳,許小樺,等.外固定器治療老年性背伸型粉碎性橈骨遠(yuǎn)端骨折的病例對(duì)照試驗(yàn)[J].中國(guó)骨傷,2009,22(9):678-680.
[21] MITTELMEIER W,BRAUN C,SCHÄFER R.The kapandji technique for fixation of distal radius fractures-a biomechanical comparison of primary stability[J].Arch Orthop Trauma Surg,2001,121(3):135-138.
[22] MIRHAMIDI S M,BAYAT F M.A prospective comparison between Kapandji and percutaneous extra-focal fixation in extra articular distal radius fractures[J].Int J Clin Exp Med,2013,6(2):133-139.

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(收稿日期:2019-09-18 本文編輯:楊雅)
更新日期/Last Update: 2020-03-10