rayback ⅳ型桡骨远端骨折治疗策略

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1、授予单位代码10089学号或申请号13739HebeiMedicalUniversity硕士学位论文RaybackIV型桡骨远端骨折治疗策略作者姓名：陈胜乐导师：王增立教授专业：外科学二级学院：石油临床医学院2015年03月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师（或指导小组）的指导下，由本人独立完成。本学位论文研究所获得的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文，第一署名为单位河北医科大学，试验材料

2、、原始数据、申报的专利等知识产权均归河北医科大学所有。否贝应法律责任。研究生签名；Pi导师签爾河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外，文中不包含其他人己经发表或撰写的研究成果，指导教师对此进行了审定。本论文由本人独立撰写，文责自负。研究生签名;导师签章目录中文摘要·············································································1英文摘

3、要·············································································3研究论文RaybackIV型桡骨远端骨折治疗策略前言·············································································6材料与方法···································································

4、·7结果·············································································11附图·············································································12附表·············································································17讨论········

5、·····································································19结论·············································································22参考文献·······································································23综述RaybackIV型桡骨远端骨折治疗进展····

6、····························29致谢···················································································36个人简历·············································································37中文摘要RaybackIV型桡骨远端骨折治疗策略摘要目的：桡骨远端骨折是指距桡骨远端关节面3cm以内的骨折，是

7、骨科医师最常见的骨折之一，约占全身骨折的1/6。Rayback依据骨折移位情况及是否累及关节面，将桡骨远端骨折分为四型，其中I、II、III型骨折多可采用保守治疗，而对RaybackIV型骨折的治疗方法则仍有争议。本研究对保守治疗及手术治疗两种方法的临床治疗效果进行比较。方法：选取2010年10月至2013年10月就诊于中国石油天然气集团公司中心医院及德国WaldKrankenhaus医院诊断为RaybackIV型桡骨远端骨折的患者125例作为研究对象。入选标准：（1）患肢无手术史，受伤前可正常活动；（2

8、）无继发性骨质疏松、代谢性骨病等疾病史；（3）无重大全身系统性疾病，能耐受手法复位术或切开复位内固定术。65岁以上患者共60例，其中手术治疗26例，保守治疗34例；65岁以下患者共65例，其中手术治疗41例，保守治疗24例。保守治疗方法：采用手法复位石膏托固定，根据具体情况采用或不采用利多卡因局部浸润麻醉，在对抗下沿其纵轴对患肢进行牵引，而后对骨折部位进行移位矫正，手法复位后石膏托进行固定，并对骨折复位情况进行X线检查。骨折复