Agee J M, Szabo R M, Chidgey L K, King F C, Kerfoot C
Hand Biomechanics Lab, Inc, Sacramento, Calif.
Orthopedics. 1994 Dec;17(12):1115-22. doi: 10.3928/0147-7447-19941201-05.
Following dorsally displaced fractures of the distal radius, the classic position of immobilization is with the wrist flexed and in ulnar deviation. This is not the position of function and entails morbidity in the form of finger stiffness, which may require prolonged rehabilitation. We treated 20 consecutive, comminuted, intraarticular distal radial fractures using a new external fixation system with the wrist in a neutral to extended position, thereby promoting metacarpophalangeal joint flexion by relatively relaxing the finger extensor tendons. Supplemental pin fixation was used in eight cases. Most patients were performing active digital motion on the day of surgery and 95% maintained functional finger motion during treatment. All fractures healed uneventfully. Palmar tilt was restored in 55% of patients in spite of a wrist neutral or extended position. This method of fixing distal radial fractures allows restoration of anatomy while avoiding hand stiffness.
桡骨远端背侧移位骨折后，经典的固定位置是腕关节屈曲并尺偏。这并非功能位，会导致手指僵硬等并发症，可能需要长期康复治疗。我们使用一种新的外固定系统，将腕关节置于中立位至伸展位，连续治疗了20例粉碎性桡骨远端关节内骨折，从而通过相对放松手指伸肌腱来促进掌指关节屈曲。8例患者使用了辅助钢针固定。大多数患者在手术当天即可进行主动手指活动，95%的患者在治疗期间保持了手指的功能活动。所有骨折均顺利愈合。尽管腕关节处于中立位或伸展位，55%的患者恢复了掌倾角。这种固定桡骨远端骨折的方法能够在避免手部僵硬的同时恢复解剖结构。
