Effectiveness of arthroscopy-assisted combined fixation of Kirschner wire and external fixator for treating extreme distal radial fractures_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YIN Fei , RUI Yongjun ,  LI Fengfeng , LIU Jun , WU Yongwei , LU Yao , MA Yunhong , SUN Zhenzhong

Department of Orthopedics, Wuxi Orthopedic Hospital Affiliated to Soochow University (the Ninth People’s Hospital of Wuxi City), Wuxi Jiangsu, 214000, P.R.China;

Corresponding author：

LI Fengfeng, Email: yfseu0126@126.com

Keywords：

Extreme distal radial fracture; arthroscopy; external fixator; Kirschner wire

DOI：

10.7507/1002-1892.201704091

Video：

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Objective To investigate the effectiveness of arthroscopy-assisted combined fixation of Kirschner wire and external fixator for treating extreme distal radial fractures. Methods Between January 2014 and May 2016, 21 patients who suffered from extreme distal radial fractures were treated by arthroscopy-assisted combined fixation of Kirschner wire and external fixator. There were 14 males and 7 females with an age of 32-57 years (mean, 42.3 years). The causes of injury included falling in 13 cases and traffic accident in 8 cases. The fracture type included 8 cases of type 23C1, 9 cases of type 23C2, and 4 cases of type 23C3 according to AO/OTA classification. The time from injury to operation was 3-7 days (mean, 4.4 days). The Mayo score and disability of arm, shoulder, and hand (DASH) score were used to assess the pain and function of the wrist joint. Results There was no needle red swelling, tendon irritation, or orther early complications. All the patients were followed up 10-35 months (mean, 18.3 months). The fracture healing time was 9-13 weeks (mean, 10.6 weeks). At last follow-up, the Mayo score was 87-94 (mean, 90.9); and 17 cases were excellent and 4 were good. The DASH score was 7-13 (mean, 10.6). Conclusion Arthroscopy-assisted combined fixation of Kirschner wire and external fixator for treating extreme distal radial fractures has the advantages of firm fixation, early functional exercise, less postoperative complications, and good functional recovery of wrist joint.

Citation： YIN Fei, RUI Yongjun, LI Fengfeng, LIU Jun, WU Yongwei, LU Yao, MA Yunhong, SUN Zhenzhong. Effectiveness of arthroscopy-assisted combined fixation of Kirschner wire and external fixator for treating extreme distal radial fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(12): 1414-1417. doi: 10.7507/1002-1892.201704091 Copy

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10.	蔡宇, 周华军, 韩红, 等. 早期康复促进桡骨远端骨折术后腕关节功能康复的临床研究. 中华手外科杂志, 2016, 32(5): 374-376.
11.	王炳祺, 秦文艺, 孙玉福, 等. 锚钉一期固定治疗桡骨远端骨折并发的三角纤维软骨复合体损伤. 中国修复重建外科杂志, 2015, 29(9): 1183-1185.
12.	王立, 邵新中, 张哲敏, 等. 腕关节镜辅助下闭合复位外固定治疗桡骨远端骨折. 中华手外科杂志, 2014, 30(5): 324-326.
13.	韩兴文, 何晶晶, 王文己. 克氏针与钢板固定桡骨远端骨折疗效的荟萃分析. 中国矫形外科杂志, 2017, 25(10): 898-902.
14.	杨召, 苑珍珍, 马剑雄, 等. 切开复位内固定与外固定治疗不稳定桡骨远端骨折术后并发症的荟萃分析. 中华医学杂志, 2016, 96(47): 3833-3837.
15.	王晓峰, 陈宏, 滕晓峰, 等. 关节镜辅助下治疗桡骨远端 C 型骨折. 中华手外科杂志, 2014, 30(6): 425-427.
16.	姜保国. 桡骨远端骨折的治疗. 中华创伤骨科杂志, 2006, 8(3): 236-239.
17.	王东昕, 韩鑫, 李志德, 等. 影响桡骨远端骨折有限切开复位外固定架联合克氏针固定术后功能恢复的相关因素分析. 中国矫形外科杂志, 2017, 25(2): 97-101.

1. 郑上团, 吴斗, 郝海虎, 等. 桡骨远端骨折的治疗进展. 中华骨科杂志, 2016, 36(5): 314-320.
2. 姜宗圆, 马涛, 夏江, 等. 蝶形锁定钢板在复杂桡骨远端骨折中的应用. 中国修复重建外科杂志, 2014, 28(6): 665-668.
3. Bini A, Surace MF, Pilato G. Complex articular fractures of the distal radius: the role of closed reduction and external fixation. J Hand Surg (Eur Vol), 2008, 33(3): 305-310.
4. 杨志全, 李海生. 两种手术方法治疗桡骨远端粉碎性骨折的临床效果. 中国矫形外科杂志, 2015, 23(18): 1719-1721.
5. 劳永锵, 王明爽, 梁伟春, 等. 桡骨远端骨折内固定术后两种康复锻炼方法比较. 中国矫形外科杂志, 2016, 24(10): 894-897.
6. 樊健, 蒋波, 袁锋, 等. 桡骨极远端骨折的临床特点及治疗策略. 中华外科杂志, 2016, 54(10): 766-771.
7. Gelssler WB, Frecland AE, Savoie FH, et al. Intracarpal softtissue lesions associated with an intra-articular fracture of the distal end of the radius. J Bone Joint Surg (Am), 1996, 78(3): 357-365.
8. 王古衡, 谢仁国, 茅天, 等. C 型桡骨远端骨折掌侧内固定中接骨板不同位置对疗效影响. 中华手外科杂志, 2016, 32(2): 116-119.
9. Gutiérrez-Espinoza H, Rubio-Oyarzún D, Olguín-Huerta C, et al. Supervised physical therapy vs home exercise program for patients with distal radius fracture: A single-blind randomized clinical study. J Hand Ther, 2017, 30(3): 242-252.
10. 蔡宇, 周华军, 韩红, 等. 早期康复促进桡骨远端骨折术后腕关节功能康复的临床研究. 中华手外科杂志, 2016, 32(5): 374-376.
11. 王炳祺, 秦文艺, 孙玉福, 等. 锚钉一期固定治疗桡骨远端骨折并发的三角纤维软骨复合体损伤. 中国修复重建外科杂志, 2015, 29(9): 1183-1185.
12. 王立, 邵新中, 张哲敏, 等. 腕关节镜辅助下闭合复位外固定治疗桡骨远端骨折. 中华手外科杂志, 2014, 30(5): 324-326.
13. 韩兴文, 何晶晶, 王文己. 克氏针与钢板固定桡骨远端骨折疗效的荟萃分析. 中国矫形外科杂志, 2017, 25(10): 898-902.
14. 杨召, 苑珍珍, 马剑雄, 等. 切开复位内固定与外固定治疗不稳定桡骨远端骨折术后并发症的荟萃分析. 中华医学杂志, 2016, 96(47): 3833-3837.
15. 王晓峰, 陈宏, 滕晓峰, 等. 关节镜辅助下治疗桡骨远端 C 型骨折. 中华手外科杂志, 2014, 30(6): 425-427.
16. 姜保国. 桡骨远端骨折的治疗. 中华创伤骨科杂志, 2006, 8(3): 236-239.
17. 王东昕, 韩鑫, 李志德, 等. 影响桡骨远端骨折有限切开复位外固定架联合克氏针固定术后功能恢复的相关因素分析. 中国矫形外科杂志, 2017, 25(2): 97-101.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of arthroscopy-assisted combined fixation of Kirschner wire and external fixator for treating extreme distal radial fractures

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