不安定型橈骨遠位端骨折に対する創外固定法の適応と問題点

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  • Indications for, and Problems with, External Fixation for Unstable Distal Radius Fracture

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We report the clinical outcome of surgical treatment for distal radius fracture using external fixation. During the period 2004-2007, 15 patients (5 men and 10 women) with a mean age of 58.0 years (range, 39-75 years) were enrolled in this study. The average follow-up period was 2 years 6 months (range: 3 months to 4 years 7 months).<br>All of the fractures were of the unstable type. X-ray evaluation was performed with ulnar plus variance (UV), volar tilt (VT) and radial inclination (RI). The clinical outcome was evaluated in terms of the Cooney score and Saito's point system. The postoperative VT and RI were markedly improved in comparison with the preoperative values. However, UV shortening deformity gradually regressed to the preoperative state. Clincal evaluation was excellent or good at 56.3% in terms of the Cooney score, and 100% by Saito's point system. Almost all of the patients expressed satisfaction, but the Cooney score was not always good. We consider that external fixation is useful not only for cases of open fracture or marked soft tissue swelling around the wrist joint, but also for severe fracture at the joint surface, and that it is also effective when used with a locking plate, depending on the circumstances.

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