掌侧开窗撬拨技术在老年桡骨远端骨折手术中的应用OA
Application of palmar incision and levering technique in the surgical treatment of distal radius fractures in elderly
目的:探讨掌侧开窗撬技术治疗老年桡骨远端骨折手术的临床疗效.方法:自2022年10月至2023年12月收治手术治疗的桡骨远端骨折患者28例,其中男10例,女18例;年龄68(64,72)岁;病程3(2,7)d;骨密度T值-3.1(-2.7,-3.3);左侧11例,右侧17例;摔伤19例,车祸伤9例;AO分型,A3型20例,C2型8例.观察并比较治疗前及末次随访掌倾角、尺偏角及桡骨高度的变化情况,并采用改良Mayo腕关节评分(modified Mayo wrist score,MMWS)评价腕关节功能恢复情况,观察骨折愈合及并发症发生情况.结果:所有患者获得随访,时间11(9,13)个月.所有患者未出现切口感染、骨折复位再丢失、骨折不愈合等并发症.掌倾角、尺偏角、桡骨高度分别由术前的(-2.7±1.5)°、(16.2±2.7)°、(2.1±1.3)mm,改善至末次随访时的(12.1±2.6)°、(20.6±2.1)°、(10.5±1.2)mm,差异均有统计学意义(P<0.05);末次随访时,MMWS评分为(94.3±3.7)分,其中优23例,良5例.结论:掌侧开窗撬拨技术治疗骨质疏松性桡骨远端骨折患者能够较好地恢复桡骨掌倾角,配合人工骨的植入能有效维持骨折复位,减少再移位的风险.
Objective To explore clinical efficacy of palmar incision and levering technique in the surgical treatment of distal radius fractures in the elderly.Methods From October 2022 to December 2023,28 patients with distal radius fractures who underwent surgical treatment were admitted.Among them,including 10 male and 18 female;the age was 68(64,72)years old;the disease duration was 3(2,7)days;bone density was-3.1(-2.7,-3.3);11 patients on the left side and 17 patients on the right side;19 patients caused by injuries,and 9 patients caused by traffic accidents;according to AO classification,20 pa-tients with type A3 and 8 patients with type C2.Palmar inclination angle,ulnar deviation angle and radial height before treat-ment and the latest follow-up were observed and compared.The modified Mayo wrist score(MMWS)was used to evaluate the recovery of wrist joint function.The fracture healing and the occurrence of complications were also observed.Results All pa-tients were followed up for 11(9,13)months.None of patients experienced complications such as incision infection,re-loss of fracture reduction,or non-union of fractures.The palmar inclination angle,ulnar deviation angle,and radial height improved from(-2.7±1.5)°,(16.2±2.7)°,and(2.1±1.3)mm before treatment to(12.1±2.6)°,(20.6±2.1)°,and(10.5±1.2)mm at the latest follow-up,and the differences were statistically significant(P<0.05);at the latest follow-up,MMWS score was(94.3±3.7)points,with 23 patients got excellent result and 5 good.Conclusion Palmar window dislocation technique for treating patients with osteoporotic distal radius fractures could effectively restore palmar inclination angle of radius.Combined with the implan-tation of artificial bone,it could effectively maintain the fracture reduction and reduce risk of re-displacement.
胡劲涛;姚军;缪智敏;阮立奇
浙江中医药大学附属杭州市中医院骨伤科,浙江 杭州 310007浙江中医药大学附属杭州市中医院骨伤科,浙江 杭州 310007浙江中医药大学附属杭州市中医院骨伤科,浙江 杭州 310007浙江中医药大学附属杭州市中医院骨伤科,浙江 杭州 310007
医药卫生
桡骨远端骨折骨折固定术老年骨折手法复位
Distal radius fractureFracture fixationElderlyManipulative reduction of fracture
《中国骨伤》 2026 (3)
235-239,5
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