Capo John T, Swan Kenneth G, Tan Virak
University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey 07103, USA.
Clin Orthop Relat Res. 2006 Apr;445:30-41. doi: 10.1097/01.blo.0000205898.21233.f5.
Fractures of the distal radius are common injuries. Low-energy or high-energy mechanisms may be involved. Unstable distal radius fractures present a challenge to the treating orthopaedic surgeon. External fixation is a valuable instrument for fracture reduction and stabilization. Limited open incisions, early range of motion, and treatment of complex wounds are a few of the benefits of external fixation. Fixators may be spanning or nonbridging and may be used alone or in combination with other stabilization methods to obtain and maintain distal radius fracture reduction. Augmentation with percutaneous wires allows for optimal fracture stabilization with physiologic alignment of the wrist. Moderate distraction at the carpus does not induce postoperative stiffness. The distal radioulnar joint must be assessed and may need to be stabilized. Complications of external fixation are usually minor, but must be anticipated and treated early.
Level V (expert opinion).
桡骨远端骨折是常见损伤。可能涉及低能量或高能量机制。不稳定的桡骨远端骨折给骨科治疗医生带来挑战。外固定是骨折复位和稳定的一种有价值的手段。有限的开放切口、早期活动范围以及复杂伤口的处理是外固定的一些优点。固定器可以是跨越型或非桥接型,可单独使用或与其他稳定方法联合使用以实现并维持桡骨远端骨折复位。经皮穿针增强固定可实现腕关节生理对线的最佳骨折稳定。腕关节适度牵张不会导致术后僵硬。必须评估下尺桡关节,可能需要对其进行稳定。外固定的并发症通常较轻,但必须提前预料并尽早处理。
V级(专家意见)。