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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2.	姜宗圓, 馬濤, 夏江, 等. 蝶形鎖定鋼板在復雜橈骨遠端骨折中的應用. 中國修復重建外科雜志, 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.	楊志全, 李海生. 兩種手術方法治療橈骨遠端粉碎性骨折的臨床效果. 中國矯形外科雜志, 2015, 23(18): 1719-1721.
5.	勞永鏘, 王明爽, 梁偉春, 等. 橈骨遠端骨折內固定術后兩種康復鍛煉方法比較. 中國矯形外科雜志, 2016, 24(10): 894-897.
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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, 謝仁國, 茅天, 等. C 型橈骨遠端骨折掌側內固定中接骨板不同位置對療效影響. 中華手外科雜志, 2016, 32(2): 116-119.
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10.	蔡宇, 周華軍, 韓紅, 等. 早期康復促進橈骨遠端骨折術后腕關節功能康復的臨床研究. 中華手外科雜志, 2016, 32(5): 374-376.
11.	王炳祺, 秦文藝, 孫玉福, 等. 錨釘一期固定治療橈骨遠端骨折并發的三角纖維軟骨復合體損傷. 中國修復重建外科雜志, 2015, 29(9): 1183-1185.
12.	王立, 邵新中, 張哲敏, 等. 腕關節鏡輔助下閉合復位外固定治療橈骨遠端骨折. 中華手外科雜志, 2014, 30(5): 324-326.
13.	韓興文, 何晶晶, 王文己. 克氏針與鋼板固定橈骨遠端骨折療效的薈萃分析. 中國矯形外科雜志, 2017, 25(10): 898-902.
14.	楊召, 苑珍珍, 馬劍雄, 等. 切開復位內固定與外固定治療不穩定橈骨遠端骨折術后并發癥的薈萃分析. 中華醫學雜志, 2016, 96(47): 3833-3837.
15.	王曉峰, 陳宏, 滕曉峰, 等. 關節鏡輔助下治療橈骨遠端 C 型骨折. 中華手外科雜志, 2014, 30(6): 425-427.
16.	姜保國. 橈骨遠端骨折的治療. 中華創傷骨科雜志, 2006, 8(3): 236-239.
17.	王東昕, 韓鑫, 李志德, 等. 影響橈骨遠端骨折有限切開復位外固定架聯合克氏針固定術后功能恢復的相關因素分析. 中國矯形外科雜志, 2017, 25(2): 97-101.

1. 鄭上團, 吳斗, 郝海虎, 等. 橈骨遠端骨折的治療進展. 中華骨科雜志, 2016, 36(5): 314-320.
2. 姜宗圓, 馬濤, 夏江, 等. 蝶形鎖定鋼板在復雜橈骨遠端骨折中的應用. 中國修復重建外科雜志, 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. 楊志全, 李海生. 兩種手術方法治療橈骨遠端粉碎性骨折的臨床效果. 中國矯形外科雜志, 2015, 23(18): 1719-1721.
5. 勞永鏘, 王明爽, 梁偉春, 等. 橈骨遠端骨折內固定術后兩種康復鍛煉方法比較. 中國矯形外科雜志, 2016, 24(10): 894-897.
6. 樊健, 蔣波, 袁鋒, 等. 橈骨極遠端骨折的臨床特點及治療策略. 中華外科雜志, 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, 謝仁國, 茅天, 等. C 型橈骨遠端骨折掌側內固定中接骨板不同位置對療效影響. 中華手外科雜志, 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, 周華軍, 韓紅, 等. 早期康復促進橈骨遠端骨折術后腕關節功能康復的臨床研究. 中華手外科雜志, 2016, 32(5): 374-376.
11. 王炳祺, 秦文藝, 孫玉福, 等. 錨釘一期固定治療橈骨遠端骨折并發的三角纖維軟骨復合體損傷. 中國修復重建外科雜志, 2015, 29(9): 1183-1185.
12. 王立, 邵新中, 張哲敏, 等. 腕關節鏡輔助下閉合復位外固定治療橈骨遠端骨折. 中華手外科雜志, 2014, 30(5): 324-326.
13. 韓興文, 何晶晶, 王文己. 克氏針與鋼板固定橈骨遠端骨折療效的薈萃分析. 中國矯形外科雜志, 2017, 25(10): 898-902.
14. 楊召, 苑珍珍, 馬劍雄, 等. 切開復位內固定與外固定治療不穩定橈骨遠端骨折術后并發癥的薈萃分析. 中華醫學雜志, 2016, 96(47): 3833-3837.
15. 王曉峰, 陳宏, 滕曉峰, 等. 關節鏡輔助下治療橈骨遠端 C 型骨折. 中華手外科雜志, 2014, 30(6): 425-427.
16. 姜保國. 橈骨遠端骨折的治療. 中華創傷骨科雜志, 2006, 8(3): 236-239.
17. 王東昕, 韓鑫, 李志德, 等. 影響橈骨遠端骨折有限切開復位外固定架聯合克氏針固定術后功能恢復的相關因素分析. 中國矯形外科雜志, 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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