创伤性腕部轴向骨折与脱位的治疗

发布时间：2018-01-03 22:08

本文关键词：创伤性腕部轴向骨折与脱位的治疗　出处：《吉林大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:探讨创伤性腕部轴向骨折与脱位的治疗、并发症及预后。方法:回顾性分析2004年11月至2016年3月收治的8例创伤性腕部轴向骨折与脱位患者资料,男5例,女3例;年龄为32~48岁,平均36岁;右侧4例,左侧4例。致伤原因:挤压伤6例,压砸伤2例。根据Garcia-Elias分类:尺侧轴向骨折与脱位型6例,桡侧轴向骨折与脱位型1例,混合型1例。2例闭合性损伤患者筋膜室行切开减张、神经减压、固定骨折与脱位;4例开放性损伤患者清创、固定骨折与脱位,一期修复肌腱、神经,其中1例二期皮瓣修复皮肤缺损,1例行腕关节融合术;2例严重开放性损伤患者清创、固定骨折与脱位,一期修复肌腱、神经,二期由于感染等并发症而截肢。结果:8例患者术后获4~113个月(平均73个月)随访。根据中华医学会手外科学会上肢部分功能评定试用标准评定:优2例,良1例,可2例,差3例。结论:创伤性腕部轴向骨折与脱位是腕部损伤的一种特殊类型,软组织损伤程度远大于骨与关节损伤的程度。对于闭合性损伤,应预防骨筋膜间隔综合征及腕管综合征的发生;对于开放性损伤,应重视软组织损伤,从而有利于腕关节功能的恢复。
[Abstract]:Objective: To explore the treatment of traumatic wrist axial fracture and dislocation, complications and prognosis. Methods: a retrospective analysis from November 2004 to March 2016 were 8 cases of traumatic wrist axial fracture and dislocation of patients, 5 cases were male, 3 were female; aged 32~48 years old, average 36 years old; 4 cases of right side, 4 cases of left. Injury caused by crush injury in 6 cases, crush injury in 2 cases. According to Garcia-Elias classification: 6 cases of ulnar fracture with axial dislocation, 1 cases of radial axial fracture and dislocation, 1 cases of mixed type.2 cases of closed compartment injury patients treated with open reduction, decompression, fixation of fracture and dislocation in 4 cases; open injury patients with debridement, fixation of fracture and dislocation, one stage repair of tendon, nerve, of which 1 cases of two skin flaps in the repair of skin defect, 1 cases of wrist arthrodesis; 2 cases of severe open injury in patients with debridement, fixation of fracture and dislocation, one stage repair of tendon, nerve, and two because of infection The complication and amputation. Results: 8 patients were followed for 4~113 months (average 73 months) follow-up. According to the Chinese Medical Association of hand surgery to the upper extremity functional evaluation standard: excellent 2 cases, good in 1 cases, 2 cases, poor in 3 cases. Conclusion: traumatic wrist axial fracture and dislocation is a special type of wrist injury, soft tissue injury degree is far greater than the degree of bone and joint injury. For closed injury, should prevent osteofascial compartment syndrome and carpal tunnel syndrome; for open injury, should pay attention to soft tissue injury, which is beneficial to the recovery of wrist function.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R683

【相似文献】