桡骨中上段骨折合并桡骨头脱位诊疗分析

发布时间：2019-03-14 10:23

【摘要】：[目的]探讨桡骨中上段骨折合并桡骨头脱位诊疗特点。[方法]回顾性分析本院2000年9月~2015年2月收治的桡骨中上段骨折合并桡骨头脱位患者9例。对新鲜骨折脱位:桡骨骨折行切开复位钢板内固定;桡骨小头脱位行手法复位;稳定脱位行石膏外固定。手法复位困难或者存在再脱位者,行切开复位,若探查环状韧带不完整,行环状韧带重建术,并行克氏针内固定术。对陈旧性病例,行桡骨头行切开复位,环状韧带重建或不重建,并行克氏针内固定。[结果]按照Mayo肘关节功能评分标准,优2例,良2例,可3例,差2例;优良率为44.4%。屈肘平均90°(30°~140°),伸直平均10°(0°~30°),前臂旋前平均30°(0°~55°)旋后平均35°(0°~80°)。[结论]前臂结构复杂,对桡骨骨折患者,行肘关节和腕关节X线片检查,必要时行双侧X线片的对照比较,有条件者行CT进行重建,是避免误诊和漏诊的重要因素。
[Abstract]:[Objective] To study the characteristics of the diagnosis and treatment of the fracture of the upper segment of the bone and the dislocation of the head of the bone. [Methods] 9 cases of middle-and upper-stage fracture and dislocation of the head of bone in our hospital from September 2000 to February 2015 were analyzed retrospectively. Dislocation of fresh fracture: the internal fixation of the fractured bone fracture line in the reduction steel plate; the manual reduction of the small-head dislocation of the patella; and the external fixation of the stable dislocation line plaster. The method is difficult to reset or there is a subluxation, the line is cut and reset, if the exploration of the annular ligament is incomplete, the ring-shaped ligament reconstruction is performed, and the parallel Kirschner's internal fixation is performed. In the case of old cases, the bone head of the line was cut and reset, the annular ligament was reconstructed or not reconstructed, and the parallel Kirschner's needle was fixed. [Results] The excellent and good rate was 44.4%, according to the Mayo Elbow Functional Standard, the excellent 2 cases, the good 2 cases, the 3 cases and the poor 2 cases. The average bend angle is 90 掳 (30 掳 ~ 140 掳), the straight average is 10 掳 (0 掳 ~ 30 掳), and the average of the forearm pronation is 30 掳 (0 掳 ~ 55 掳) and the average is 35 掳 (0 掳 ~ 80 掳). [Conclusion] The structure of the forearm is complicated, and the X-ray of the elbow joint and the wrist joint of the patients with the fracture of the bone fracture is examined. The contrast of the bilateral X-rays is compared with the control of the bilateral X-rays, and the CT of the conditioned person is used for reconstruction, which is an important factor to avoid misdiagnosis and missed diagnosis.
【作者单位】：湖北医药学院附属东风医院骨科研究所;
【基金】：湖北省卫生计生科研基金资助(编号:WJ2015MB217) 2014年十堰市科学技术研究与开发项目计划资助(编号:14K72) 湖北医药学院2014年度优秀中青年科技创新团队自主计划项目资助(编号:2014CXZ04);湖北医药学院2014年教学研究立项项目(校级一般课题)(编号:2014059)
【分类号】：R687.3

【相似文献】