桡骨远端骨折桡骨远端骨折桡骨远端骨折桡骨远端骨折 XXX创伤科提 纲 定义 流行病学 解剖学和生物力学 发病机制 骨折分类 诊断 治疗 进展和争论定 义 桡骨远端骨折是指距桡 骨远端关节面3cm 以内的骨折 3cm流行病学特征 发病率：人类全身最常见的骨折, 其发病率约占急诊骨折病人的17 %种族：无人种差异年龄：双峰分布 5-14 岁 ——关节内骨折 60-69 岁 ——关节外骨折性别：老年人 男: 女=1:4 青春期：男: 女=3 :1应用解剖Lister 结节桡骨掌侧结节月骨关节突PQ = Pronator Quadratus Line （旋前方肌线）WS = Watershed Line （分水岭线）X = Volar Radial Tuberosity （掌侧桡骨结节）VRV lR di l Rid（掌侧桡骨嵴）旋前方肌线分水岭线The arrow marks the most volar portion of the radius, called the Watershed Line侧位X 线解剖桡骨远端骨折块的构成桡骨远端背侧的肌腱相关的生物力学三柱理论80% 负荷由桡骨远端承担，20% 的负荷由腕三角软骨承担骨折发病机制及分类 骨折分类系统是一种有效的工具，它能帮助骨科医生为各种特定的骨折给出适当的治疗方案；同时也有助于对疾病的预后作出合理的判断 ------Albert H. Burstein, PhD, Deputy Editor for Research, Journal of Bone and Joint Surgery Colles 与smith 骨折的受伤机制诊断 外伤史 局部肿胀、疼痛、腕关节功能障碍 压痛、纵轴叩击痛及骨擦音 畸形 辅助检查 结合中医理论两种畸形的比较colles 骨折smith 骨折辅助检查X-ray CT MRI 关节镜检查X-ray 测量正位：尺偏角正位：桡骨高度 尺骨方差侧位：掌倾角0.9mm 10°-15°10°-15°泪滴角Teardrop angle>45°Colles' fracture is an extraarticular low energy fracture primarily sustained in the elderly, a fracture almost unique to caucasian women.a "classic" Colles' fractureAbraham Colles Colles 骨折 (1814)Smith’s 骨折 1847Robert William Smith considered this "an injury of exceedingly rare occurrence," but its description heralded the age of vehicular trauma in 1847:The patient, in endeavouring to save himself from being run over by a car, fell with great viole...
