闭合复位外固定架辅助克氏针治疗桡骨远端不稳定骨折的疗效分析

Analysis of curative effect of closed reduction external fixator assisted Kirschner needle in the treatment of unstable fracture of distal radius

摘要:

摘要：[目的]分析应用闭合复位外固定架并部分结合克氏针固定的方法治疗桡骨远端不稳定骨折的临床疗效。[方法] 选取2019.03-2021.09月收住院的30例桡骨远端不稳定骨折的患者资料纳入本次研究，均行闭合复位外固定架治疗，收集患者围手术期相关资料，比较术前、术后的Cooney腕关节功能评分以及掌倾角、尺偏角、桡骨茎突高度等影像学资料进行评价。[结果] 30例患者均获得骨折愈合，无切口感染、外固定钉道感染、神经、血管损伤情况，无外固定架单臂、螺钉松动状况。腕关节Cooney功能评分术后3月、术后6月均较术前显著增加明显，差异具有统计学意义（P＜0.01），掌倾角、尺偏角、桡骨茎突高度等三方面指标情况，术后即刻、术后3月、术后6月均较术前改善明显，差异具有统计学意义（P＜0.05），掌倾角术后即刻、术后3月、术后6月进行两两比较，P＞0.05，差异无统计学意义。尺偏角、桡骨茎突高度术后即刻、术后3月进行两两比较，P＞0.05，差异无统计学意义。术后即刻、术后6月进行两两比较，P＜0.05，差异有统计学意义。术后3月与术后6月进行两两比较，P＜0.05，差异有统计学意义。[结论] 对于不稳定型桡骨远端骨折，外固定架辅助克氏针治疗可获得较为满意的临床疗效，可作为临床医生信赖的手术方法之一。

Abstract:

Abstract: [Objective] To analyze the clinical effect of closed reduction external fixator combined with Kirschner wire fixation in the treatment of unstable fracture of distal radius. [Methods] Data of 30 patients with unstable distal radius fractures admitted to hospital from March 2019 to September 2019 were included in this study. All patients were treated with closed reduction external fixator, and perioperative data were collected. Preoperative and postoperative Cooney wrist function scores and imaging data such as palmar inclination Angle, ulnar declination Angle and radius styloid height were compared for evaluation. [Results] Fracture healing was achieved in all 30 patients, without incision infection, infection of external fixation nail tract, nerve and blood vessel injury, and without loosening of external fixator arm or screw. Cooney function score of wrist joint was significantly increased 3 months and 6 months after operation compared with that before operation, the difference was statistically significant (P < 0.01); palmar inclination Angle, ulnar declination Angle and radius styloid height were significantly improved immediately after operation, 3 months after operation and 6 months after operation compared with that before operation, the difference was statistically significant (P < 0.05). Pairwise comparison of palmar inclination immediately after surgery, 3 months after surgery and 6 months after surgery, P > 0.05, the difference was not statistically significant. The pairwise comparison of ulnar declination Angle and radius styloid height immediately after surgery and 3 months after surgery showed no statistical significance (P > 0.05). Pairwise comparison was conducted immediately after surgery and 6 months after surgery, P < 0.05, the difference was statistically significant. Pairwise comparison was conducted 3 months after surgery and 6 months after surgery, P < 0.05, the difference was statistically significant. [Conclusion] For unstable distal radius fractures, external fixator assisted Kirschner wire can obtain satisfactory clinical effect, and can be used as one of the reliable surgical methods for clinicians.