[1]郑立程* 季滢瑶 赵政 吴纪奎.外固定支架联合Kapandji技术微创治疗老年桡骨远端不稳定骨折[J].中国微创外科杂志,2020,01(2):172-174.
　Zheng Licheng,Ji Yingyao,Zhao Zheng,et al.External Fixator Combined With Kapandji Technique for Treatment of Unstable Distal Radius Fractures in Elderly Patients[J].Chinese Journal of Minimally Invasive Surgery,2020,01(2):172-174.
点击复制

外固定支架联合Kapandji技术微创治疗老年桡骨远端不稳定骨折()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2020年2期
页码:
172-174
栏目:
经验交流
出版日期:
2020-02-28

文章信息/Info

Title:
External Fixator Combined With Kapandji Technique for Treatment of Unstable Distal Radius Fractures in Elderly Patients
作者:
郑立程* 季滢瑶 赵政 吴纪奎
（温州医科大学附属乐清医院骨科，温州325600）
Author(s):
Zheng Licheng;  Ji Yingyao;  Zhao Zheng;  et al.
Department of Orthopedics, Yueqing Affiliated Hospital of Wenzhou Medical University, Yueqing 325600, China
关键词:
桡骨骨折; 骨折固定术; 外固定架
Keywords:
Radius fracture; Fracture fixation; External fixator
文献标志码:
B
摘要:
目的探讨外固定支架联合Kapandji技术治疗老年桡骨远端不稳定骨折的疗效。方法2012年5月～2016年2月对21例老年桡骨远端不稳定骨折（按AO分型：A3型6例，B2型3例，C2型9例，C3型3例）采用外固定支架联合克氏针经皮插入以阻挡骨块再移位的Kapandji技术。末次随访根据改良的Sarmiento评分进行影像学评估，根据GartlandWerley功能评分标准进行腕关节功能评估。结果手术时间25~45 min，平均35.3 min。术后住院时间3~14 d，平均6.5 d。21例随访8～24个月，平均15.3月，骨折均获愈合。影像学评分：优17例，良4例；腕关节功能评分：优13例，良5例，可3例，优良率为85.7％（18/21）。结论外固定支架联合Kapandji技术是老年桡骨远端不稳定骨折有效的微创手术方法，易于操作，避免伸肌腱的刺激，可有效增强固定的稳定性，功能恢复良好。
Abstract:
ObjectiveTo explore the effect of external fixator combined with Kapandji technique for treatment of unstable distal radius fractures in elderly patients. MethodsA retrospective study was made on 21 elderly patients with unstable distal radius fracture from May 2012 to February 2016. All the patients were treated with external fixator combined with Kapandji technique by using percutaneous insertion of Kirschner wire to prevent fracture displacement. According to the AO classification, there were 6 cases of type A3, 3 cases of type B2, 9 cases of type C2, and 3 cases of type C3. The radiographic parameters were evaluated according to the modified Sarmiento scale at the last followup. Wrist function was assessed by using GartlandWerley scoring system.ResultsThe operation time ranged 25-45 min, with an average of 35.3 min. The postoperative hospital stay ranged 3-14 d, with an average of 6.5 d. All the 21 patients were successfully followed up for 8-24 months, with an average of 15.3 months. All the patients had a complete healing of their fractures. The radiographic manifestation was rated as excellent in 17 patients and good in 4. The GarlandWerley functional assessment rated wrist function to be excellent in 13 patients, good in 5 and fair in 3.Conclusion External fixator combined with Kapandji technique is an effective method for unstable distal radius fractures in elderly patients, which avoids the stimulation of extensor tendon with enough fixtion and obtains good clinical results.

参考文献/References:

[1]Konstantinidis L, Helwig P, Seifert J, et al. Internal fixation of dorsally comminuted fractures of the distal part of the radius: a biomechanical analysis of volar plate and intramedullary nail fracture stability. Arch Orthop Trauma Surg,2011,131(11):1529-1537.
[2]杨国栋,张相弟,朱杰鹏,等.解剖锁定钢板内固定治疗老年不稳定型桡骨远端骨折.浙江创伤外科,2013,18(2):179-180.
[3]Neto AP,Lhamby FC.Fixation of fractures of the distal extremity of the radius using the modified Kapandji technique:evaluation of the radiological results.Rev Bras Ortop,2011,46(4):368-373.
[4]Kumbaraci M, Kucuk L, Karapinar L, et al.Retrospective comparison of external fixation versus volar locking plate in the treatment of unstable intraarticular distal radius fractures.Eur J Orthop Surg Traumatol,2014,24(2):173-178.
[5]Stewart HD, Innes AR, Burkke FD.Functional castbracing for Colles’ fractures. A comparison between castbracing and conventional plaster casts.J Bone Joint Surg(Br),1984,66(5):749-753.
[6]Gartland Jr, Werley CW. Evaluation of healed colles,fractures.J Bone Joint Surg Am,1951,33(4):895-907.
[7]Bales JG, Stern PJ. Treatment strategies of distal radius fractures. Hand Clin,2012,28(2):177-184.
[8]吴官保,董克芳,许小桦,等.外固定器治疗老年性背伸型粉碎性桡骨远端骨折的病例对照试验.中国骨伤,2009,22(9):678-680.
[9]Siripakarn Y, Suntarapa T, Chernchujit B, et al. Multipurpose external fixation for unstable comminuted intraarticular fracture of distal radius.J Med Assoc Thai,2013,96(4):446-455.
[10]Mittelmeier W, Braun C, Schfer R. The Kapandji technique for fixation of distal radius fractures: a biomechanical comparison of primary stability. Arch Orthop Trauma Surg,2001,121(3):135-8.
[11]Mirhamidi SM, Bayat FM. A prospective comparison between Kapandji and percutaneous extrafocal fixation in extra articular distal radius fractures. Int J Clin Exp Med,2013,6(2):133-139.

备注/Memo

备注/Memo:
*通讯作者，Email：zlcheng007@163.com
更新日期/Last Update: 2020-05-16