闭合复位经皮加压空心钉内固定治疗桡骨远端不稳定性骨折的疗效

张立杰

摘要：目的  研究閉合复位经皮加压空心钉内固定治疗桡骨远端不稳定性骨折的疗效。方法  选取2015年3月～2019年3月在我院诊治的50例桡骨远端不稳定性骨折患者为研究对象，采用随机数字表法分为对照组和观察组，各25例。对照组采用骨折切开复位钢板内固定治疗，观察组采用闭合复位经皮加压空心钉内固定治疗，比较两组骨折治疗总优良率、手术相关指标（手术时间、术后出血量、骨折愈合时间）、腕关节活动（掌屈、背伸、旋前、旋后、桡偏、尺偏）度、桡骨高度恢复情况以及并发症发生情况。结果  观察组骨折治疗总优良率（92.00%）高于对照组（80.00%），差异有统计学意义（P<0.05）;观察组手术时间、术后出血量、骨折愈合时间均短于对照组，差异有统计学意义（P<0.05）;观察组掌屈、背伸、旋前、旋后、桡偏、尺偏及桡骨高度大于对照组，差异有统计学意义（P<0.05）;观察组并发症发生率（8.00%）低于对照组（20.00%），差异有统计学意义（P<0.05）。结论  闭合复位经皮加压空心钉内固定微创治疗桡骨远端不稳定性骨折优良率高，腕关节活动度优良，骨折愈合时间短，术后出血量少，桡骨高度高，且并发症少，值得临床应用。

关键词：闭合复位;经皮加压空心钉;微创治疗;桡骨远端;不稳定性骨折

中图分类号：R687.3                                  文献标识码：A                                DOI：10.3969/j.issn.1006-1959.2020.14.029

文章编号：1006-1959（2020）14-0100-03

Therapeutic Effect of Closed Reduction and Percutaneous Compression Hollow

Nail Internal Fixation on Unstable Fracture of Distal Radius

ZHANG Li-jie

（Department of Orthopedics，Baodi DistrictTraditional Chinese Medicine Hospital，Tianjin 301800，China）

Abstract：Objective  To study the curative effect of closed reduction and percutaneous compression internal fixation on unstable distal radius fractures.Methods  50 patients with unstable distal radius fractures diagnosed and treated in our hospital from March 2015 to March 2019 were selected as the research object. They were divided into a control group and an observation group with a random number table method， each with 25 cases. The control group was treated with open reduction and fracture plate internal fixation， and the observation group was treated with closed reduction percutaneous compression hollow nail internal fixation. The total excellent and good fracture treatment rate and surgical related indicators （operation time， postoperative bleeding volume， fracture healing） of the two groups were compared）， wrist movement （palm flexion， dorsal extension， pronation， supination， radial deviation， ulnar deviation）， radius height recovery and complications.Results  The total good rate of fracture treatment in the observation group （92.00%） was higher than that in the control group （80.00%）， the difference was statistically significant （P<0.05）; the operation time， postoperative bleeding volume， and fracture healing time of the observation group were shorter than that of the control group，the difference was statistically significant （P<0.05）; the palmar flexion， dorsal extension， pronation， supination， radial deviation， ulnar deviation， and radial height of the observation group were greater than the control group，the difference was statistically significant （P<0.05）; the observation group incidence of complications （8.00%） was lower than that of the control group （20.00%）， the difference was statistically significant （P<0.05）.Conclusion  Closed reduction and percutaneous compression cannulated screw fixation for minimally invasive treatment of distal radius unstable fractures has a high rate of excellent， good wrist mobility， short fracture healing time， less postoperative bleeding， high radius height， and fewer complications，worthy of clinical application.

Key words：Closed reduction;Percutaneously compressed hollow nail;Minimally invasive treatment; Distal radius;Unstable fracture

桡骨远端骨折（fracture of distal end of radius）是临床常见四肢骨折，依据骨折情况可分为稳定性和不稳定性[1]。手术是治疗桡骨远端不稳定性骨折的有效手段，常用的手术方式有钢板内固定、外固定架、克氏针、加压空心钉等，钢板内固定及外固定治疗桡骨远端不稳定骨折能达到一定效果，但其仍存在一定缺陷，骨折切开复位需要剥离较多软组织及骨膜，容易造成骨折不愈合[2]。研究显示[3]，不同手术方式治疗骨折愈合效果、愈合时间以及并发症发生情况均存在差异。本研究结合2018年3月～2019年3月在我院诊治的50例桡骨远端不稳定性骨折患者临床资料，观察闭合复位经皮加压空心钉内固定治疗桡骨远端不稳定性骨折的效果，现报道如下。……