Merchan E C, Breton A F, Galindo E, Peinado J F, Beltran J
La Paz Hospital, Madrid, Spain.
Orthop Rev. 1992 Oct;21(10):1203-9.
In this prospective study, 70 patients between the ages of 20 and 45 years with comminuted intra-articular fractures of the distal radius of types III to VIII (graded according to Frykman) were treated either by closed reduction and forearm plaster (35 patients) or by application of a Clyburn dynamic external fixator (35 patients). The external fixator was more effective at holding the manipulated position, and the roentgenographic loss of position during fracture union was minimal compared with that seen in patients treated in plaster. Functional results in the fixator group were 18 excellent, 10 good, 6 fair, and 1 poor. The plaster group showed the following functional results: 12 excellent, 8 good, 10 fair, and 5 poor. The external fixator generated significantly better anatomical and functional results than did treatment with forearm plaster. A good anatomic position combined with early rehabilitation of the wrist function produced very favorable functional results in patients less than 45 years of age.
在这项前瞻性研究中，70例年龄在20至45岁之间、桡骨远端III至VIII型（根据Frykman分级）关节内粉碎性骨折的患者，分别采用闭合复位加前臂石膏固定（35例患者）或应用Clyburn动力外固定器（35例患者）进行治疗。与石膏固定治疗的患者相比，外固定器在维持手法复位位置方面更有效，骨折愈合过程中X线片显示的位置丢失最小。外固定器组的功能结果为18例优、10例良、6例可、1例差。石膏组的功能结果如下：12例优、8例良、10例可、5例差。外固定器在解剖和功能方面产生的结果明显优于前臂石膏治疗。对于年龄小于45岁的患者，良好的解剖位置结合早期腕关节功能康复可产生非常理想的功能结果。
