Mostafa Mohamed F
Department of Orthopedic Surgery and Traumatology, Faculty of Medicine, Mansoura University, PO Box 2, Mansoura, 35516, Egypt,
Strategies Trauma Limb Reconstr. 2013 Aug;8(2):89-95. doi: 10.1007/s11751-013-0161-z. Epub 2013 Jun 6.
The treatment of unstable Colles-type distal radial fractures remains a challenge. A prospective study was conducted to evaluate the outcomes of the treatment of unstable distal radial fractures using antegrade intra-medullary K-wires. Twenty-eight Colles-type distal radial fractures were selected excluding comminuted intra-articular and Barton's fractures. The blunt tips of intra-medullary K-wires were introduced in an antegrade direction to support the subchondral bone of the distal fragment. The scoring system of Green and O'Brien modified by Cooney et al. was used for the final clinical evaluation. The radiological outcomes were evaluated using the scale proposed by Stewart et al. After a mean follow-up of 34 months (range 14-46), 17 patients were rated clinically excellent, seven good, three fair and one poor. The mean loss of radial height, radial inclination, volar tilt and ulnar variance was 0.9 mm, 1.9°, 0.5° and 0.4 mm, respectively. These results were comparable with the values reported in other pinning studies. Only one patient complained of skin irritation and painful bursitis in the forearm; otherwise, no complications related to tendon or nerve injury were encountered. One patient had protrusion of K-wire into the wrist joint. The technique proved to be effective in maintaining reduction in distal radial fracture with low rate of soft tissue complications.
不稳定型柯莱斯氏桡骨远端骨折的治疗仍然是一项挑战。开展了一项前瞻性研究，以评估使用顺行髓内克氏针治疗不稳定型桡骨远端骨折的疗效。选取了28例柯莱斯氏桡骨远端骨折病例，排除粉碎性关节内骨折和巴顿骨折。将髓内克氏针的钝头沿顺行方向插入，以支撑远端骨折块的软骨下骨。最终临床评估采用经库尼等人修改的格林和奥布赖恩评分系统。使用斯图尔特等人提出的量表评估放射学结果。平均随访34个月（范围14 - 46个月）后，17例患者临床评定为优，7例为良，3例为可，1例为差。桡骨高度、桡骨倾斜度、掌倾角和尺骨变异的平均丢失量分别为0.9毫米、1.9°、0.5°和0.4毫米。这些结果与其他穿针研究报告的值相当。只有1例患者抱怨前臂皮肤刺激和疼痛性滑囊炎；此外，未遇到与肌腱或神经损伤相关的并发症。1例患者克氏针突入腕关节。该技术被证明在维持桡骨远端骨折复位方面有效，软组织并发症发生率低。
