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首页> 外文期刊>Journal of Hand Surgery. American Volume >Fractures of the distal radius treated with a nonbridging external fixation technique using multiplanar k-wires.
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Fractures of the distal radius treated with a nonbridging external fixation technique using multiplanar k-wires.

机译：multi骨远端骨折采用多平面k线非桥接外固定技术治疗。

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PURPOSE: Joint-bridging external fixation is a minimally invasive treatment option for distal radius fractures. Although radial length can be restored easily the anatomic reduction of articular fragments and restoration of the normal volar tilt proves to be more difficult. A method of nonbridging hybrid fixation of distal radius fractures facilitates fracture reduction and allows for free wrist movement. METHODS: Twenty-five consecutive patients with fractures of the distal radius were treated with nonbridging external fixation for 6 weeks. The stepwise surgical technique comprised a preliminary joint-bridging construction for reduction purposes, the subsequent insertion of 3 to 4 K-wires in the distal fragment, the assembling of wires to a bar nearly parallel to the fracture line, and lastly the removal of the joint-bridging part. Clinical and radiologic evaluation was performed on the first and seventh days and at 6 weeks and 2 years after surgery. RESULTS: All fractures united. Palmar tilt (> or =0 degrees ) and articular surface (articular step-off < 2 mm) were restored in all patients whereas loss of radial length occurred in 4 patients having the distal fracture fragment secured with 3 K-wires. No radial shortening was seen in fractures with 4 K-wires inserted in the distal fragment. Functional results at 2 years after surgery showed an average extension of 55 degrees and flexion of 64 degrees without significant differences between extra-articular and intra-articular fractures. There was no extensor tendinitis or pin loosening in the distal fragment; however, 3 pin track infections of proximal pins occurred. CONCLUSIONS: This surgical technique of nonbridging external fixation is a good treatment option for distal radius fractures: it permits wrist movement. We recommend the insertion of 4 K-wires in the distal fracture fragment.
机译：目的：关节桥外固定是radius骨远端骨折的微创治疗选择。尽管可以容易地恢复radial骨的长度，但解剖上的关节碎片减少和正常手掌倾斜的恢复却更加困难。 br骨远端骨折的非桥接混合固定方法有助于减少骨折并允许腕部自由运动。方法：25例连续的radius骨远端骨折患者接受了非桥接外固定架治疗6周。逐步手术技术包括用于减少骨折的初步关节桥接结构，随后在远端片段中插入3到4条K线，将线组装成与骨折线几乎平行的棒，最后移除关节桥接部分。在手术后的第一天和第七天以及第六周和第二年进行临床和放射学评估。结果：所有骨折合并。所有患者均恢复了手掌倾斜（>或= 0度）和关节表面（关节脱离<2 mm），而4例远端骨折碎片用3条K线固定的患者发生了length骨长度的损失。在远端骨折中插入4条K线的骨折中未见径向缩短。术后2年的功能结果显示平均伸张55度，屈曲64度，关节外骨折和关节内骨折之间无明显差异。远端片段无伸肌腱炎或针头松动。但是，发生了近端3个针迹感染。结论：这种非桥接外固定手术技术是technique骨远端骨折的一种很好的治疗选择：它允许腕部运动。我们建议在远端骨折片段中插入4 K线。

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