관절면을 침범한 원위 요골골절의 수장부를 통한 관혈적 치료

Abstract

Distal radius is a part which contain distal radioulnar joint and radiocarpal joint. Distal radial fracture is occurred by direct trauma of slip down, but recent, high energy injury of traffic accident or falling down injury is increased. Closed reduction or external fixation give good result in large part but, open reduction is needed in unstable fracture or intraarticular comminuted fracture. We reviewed 16 cases of distal radial fractures operated with volar approach. The most common fracture was Frykman VIII-B type and in universal classification IV-C type. T-plate, kirschner's wire and Herbert screw were used in internal fixation and bone graft was applied in 3 cases. In case of volar Barton's fracture, displaced Smith's fracture, comminuted intraarticular fracture, more than 2mm articular incongruency and in case closed reduction cannot give anatomical reduction due to comminution and displacement, we tried open reduction and internal fixation with volar approach. Even if main fracture fragment was displaced posteriorly, in case of severe comminution, we applied internal fixation in volar non-comminuted fragment. Excellent was 6, good 7, fair 2 and poor was 1 case. Radial inclinaton was improved from 8,3°to 17.5°and volar tilting was improved from -5.4°to 8.6°.There were 2 cases of complication of pain on distal radioulnar joint. In distal radial fractures which need operative treatment, open reduction and internal fixaton with volar approach gave satisfactory result.