Objective: To investigate the effectiveness of arthroscopy-assisted combined fixation of Kirschner wire and external fixator for treating extreme distal radial fractures.
Methods: Between January 2014 and May 2016, 21 patients who suffered from extreme distal radial fractures were treated by arthroscopy-assisted combined fixation of Kirschner wire and external fixator. There were 14 males and 7 females with an age of 32-57 years (mean, 42.3 years). The causes of injury included falling in 13 cases and traffic accident in 8 cases. The fracture type included 8 cases of type 23C1, 9 cases of type 23C2, and 4 cases of type 23C3 according to AO/OTA classification. The time from injury to operation was 3-7 days (mean, 4.4 days). The Mayo score and disability of arm, shoulder, and hand (DASH) score were used to assess the pain and function of the wrist joint.
Results: There was no needle red swelling, tendon irritation, or orther early complications. All the patients were followed up 10-35 months (mean, 18.3 months). The fracture healing time was 9-13 weeks (mean, 10.6 weeks). At last follow-up, the Mayo score was 87-94 (mean, 90.9); and 17 cases were excellent and 4 were good. The DASH score was 7-13 (mean, 10.6).
Conclusion: Arthroscopy-assisted combined fixation of Kirschner wire and external fixator for treating extreme distal radial fractures has the advantages of firm fixation, early functional exercise, less postoperative complications, and good functional recovery of wrist joint.
目的: 探讨关节镜辅助下克氏针结合外固定支架治疗桡骨极远端骨折的临床效果。.
方法: 2014 年 1 月—2016 年 5 月，采用腕关节镜辅助下克氏针结合外固定支架治疗桡骨极远端骨折 21 例。其中男 14 例，女 7 例；年龄 32～57 岁，平均 42.3 岁。致伤原因：摔伤 13 例，交通事故伤 8 例。骨折按 AO/OTA 分型：23C1 型 8 例，23C2 型 9 例，23C3 型 4 例。受伤至手术时间 3～7 d，平均 4.4 d。采用腕关节 Mayo 评分及上肢功能调查量表（DASH）对患者腕关节疼痛、关节功能进行评估。.
结果: 术后无针道红肿、肌腱激惹等早期并发症发生。所有患者均获随访，随访时间 10～35 个月，平均 18.3 个月。骨折愈合时间 9～13 周，平均 10.6 周。随访期间患者均无慢性腕关节疼痛及腕关节炎表现。末次随访时腕关节 Mayo 评分为 87～94 分，平均 90.9 分，其中优 17 例、良 4 例；腕关节功能 DASH 评分为 7～13 分，平均 10.6 分。.
结论: 关节镜辅助下克氏针结合外固定支架治疗桡骨极远端骨折具有固定牢靠、便于患者早期功能锻炼、术后并发症少等优点，术后腕关节功能恢复良好。.
Keywords: Extreme distal radial fracture; Kirschner wire; arthroscopy; external fixator.