本文關(guān)鍵詞： 不穩(wěn)定橈骨遠(yuǎn)端骨折 T型鎖定加壓鋼板 外固定架 療效分析　出處：《新疆醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：評估切開復(fù)位T型鎖定加壓鋼板內(nèi)固定和有限切開外固定支架聯(lián)合克氏針內(nèi)固定兩種手術(shù)方案治療不穩(wěn)定型橈骨遠(yuǎn)端骨折的臨床療效,探討不穩(wěn)定橈骨遠(yuǎn)端骨折治療方案的選擇。方法：以2012年9月至2014年9月新疆醫(yī)科大學(xué)第五附屬醫(yī)院骨科收入院采用手術(shù)治療的不穩(wěn)定橈骨遠(yuǎn)端骨折患者為研究對象,根據(jù)診斷標(biāo)準(zhǔn)、納入標(biāo)準(zhǔn)及排除標(biāo)準(zhǔn)選取符合要求的患者共51例(51側(cè))。其中男性24例,女性27例,平均年齡56歲。左側(cè)20例,右側(cè)31例。根據(jù)AO分型, B型28側(cè),C型23側(cè)。切開復(fù)位內(nèi)固定組26例,有限切開外固定架聯(lián)合克氏針內(nèi)固定組25例。記錄手術(shù)時間,術(shù)后3個月、6個月隨訪時測量腕關(guān)節(jié)活動度(背伸、掌屈、尺偏、橈偏)及相關(guān)影像學(xué)資料(掌傾角、尺偏角、橈骨縮短、關(guān)節(jié)面恢復(fù)情況),依據(jù)Gartland-Werley功能評分對患者腕關(guān)節(jié)功能進(jìn)行評價,對兩組資料進(jìn)行分析研究。結(jié)果：ORIF組平均手術(shù)時間約76分鐘,IFEF組約55分鐘。術(shù)后51例患者全部得到隨訪,經(jīng)過6-12個月的臨床隨訪觀察所有患者均達(dá)到了骨性愈合。ORIF組有切口感染1例；IFEF組有釘?shù)栏腥?例。在隨訪期間對比ORIF組腕關(guān)節(jié)活動度及相關(guān)影像學(xué)數(shù)據(jù)與IFEF組無明顯差異。根據(jù)Gartland-Werley功能評價表進(jìn)行評價,ORIF組：優(yōu)14例,良10例,可2例,優(yōu)良率92.31%；IFEF組：優(yōu)8例,良15例,可2例,優(yōu)良率92%,兩組患者均獲得滿意的腕關(guān)節(jié)功能恢復(fù),兩組優(yōu)良率無明顯差異。結(jié)論：切開復(fù)位T型鎖定加壓鋼板內(nèi)固定和有限切開外固定架聯(lián)合克氏針內(nèi)固定兩種手術(shù)方案治療不穩(wěn)定型橈骨遠(yuǎn)端骨折,腕關(guān)節(jié)功能恢復(fù)無差異。
[Abstract]:Objective: to evaluate the clinical effect of open reduction with T-locking compression plate internal fixation and limited open external fixation with Kirschner needle fixation in the treatment of unstable distal radius fractures. To explore the treatment of unstable distal radius fracture. Patients with unstable distal radius fractures treated surgically in Department of Orthopaedics, 5th affiliated Hospital of Xinjiang Medical University from September 2012 to September 2014 were studied. According to the diagnostic criteria, 51 patients were selected according to the criteria of inclusion and exclusion, including 24 males and 27 females, with an average age of 56 years and 20 patients on the left side. According to AO classification, there were 28 cases of type B and 23 sides of type C, 26 cases of open reduction and internal fixation group and 25 cases of limited open external fixation frame combined with Kirschner needle fixation group. The operation time was recorded. The wrist motion (dorsal extension, palmar flexion, ulnar deviation, radial deviation) and related imaging data (metacarpal inclination, ulnar angle, radius shortening, articular surface recovery) were measured 3 months and 6 months after operation. The wrist function was evaluated according to the Gartland-Werley score and the data of the two groups were analyzed. Results the average operation time of the two groups was about 76 minutes. IFEF group was about 55 minutes. All the 51 patients were followed up after 6 to 12 months of clinical follow-up. All the patients achieved bone healing. 1 case in the ORIF group had incision infection. There were 5 cases of nail infection in IFEF group. There was no significant difference in wrist motion and related imaging data between ORIF group and IFEF group during the follow-up period. According to Gartland-Werley function, there was no significant difference between the two groups. The evaluation forms are evaluated. ORIF group: excellent 14 cases, good 10 cases, fair 2 cases, excellent and good rate 92.31; IFEF group: excellent in 8 cases, good in 15 cases, fair in 2 cases, excellent and good rate was 92%. Conclusion: open reduction with T-type locking compression plate and limited open and external fixation with Kirschner's needle for the treatment of unstable distal radius fractures. There was no difference in wrist function recovery.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3
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本文編號：1451492