Department of Orthopaedic Surgery, Medical School, University of Patras, Rion 26504, Greece.
Injury. 2010 Mar;41(3):306-11. doi: 10.1016/j.injury.2009.09.011.
Unstable distal radius fractures remain a challenge for the treating orthopaedic surgeon. We present a retrospective follow-up study (mean follow-up 12.5 months) of 20 patients with 21 unstable distal radius fractures that were reduced in a closed manner and stabilized with a nonbridging Ilizarov external fixator. Subsequent insertion of olive wires for interfragmentary compression was performed in cases with intra-articular fractures. According to the overall evaluation proposed by Gartland and Werley scoring system 12 wrists were classified as excellent, 6 as good, 2 as fair and 1 as poor. Grade II pin-tract infection in distal fracture fragment was detected in 3 wires from a total of 78 (3.8%) and in 4 half pins out of a total of 9 (44.4%). Pronation was the most frequently impaired movement. This was restricted in 4 patients (19%) in whom a radioulnar transfixing wire was applied. Symptoms of irritation of superficial sensory branch of the radial nerve occurred in 3 patients with an olive wire applied in a closed manner in the distal fragment. Ilizarov method yields functional results comparable to that of other methods whilst it avoids wrist immobilization, open reduction and reoperation for implant removal. The method is associated with a low rate of major complication and satisfactory functional outcome.
不稳定的桡骨远端骨折仍然是治疗骨科医生的一个挑战。我们对 20 例 21 处不稳定桡骨远端骨折患者进行了回顾性随访研究（平均随访 12.5 个月），这些患者均采用闭合复位和非桥接伊里扎洛夫外固定架固定。对于关节内骨折，采用橄榄形骨针进行关节内骨折的加压。根据 Gartland 和 Werley 评分系统的总体评估，12 腕关节被评为优秀，6 个为良好，2 个为可接受，1 个为差。总共 78 根（3.8%）和总共 9 根（44.4%）的半针中有 3 根和 4 根出现远端骨折碎片的 II 级针道感染。旋前运动是最常受影响的运动。在应用桡尺骨贯穿固定针的 4 名患者（19%）中，出现了这种受限。3 名患者采用闭合方式在远端骨块中应用橄榄形骨针，出现了桡神经浅支感觉支刺激症状。伊里扎洛夫法的功能结果与其他方法相当，但避免了腕关节固定、切开复位和因去除植入物而再次手术。该方法的主要并发症发生率低，功能结果满意。
