摘要
目的研究锁定加压钢板治疗累及桡骨远端粉碎性骨折的效果。方法26例桡骨远端骨折，平均年龄61岁。按照AO骨折分型：C1型8例；C2型12例；C3型6例。其中2例为开放性骨折，另2例分别合并肩与肘关节脱位。均采用掌侧入路，T型锁定钢板固定。结果26例术后随访6～20个月．平均8个月。骨折平均愈合时间为8周（6～12周）。腕关节活动度平均为：掌屈40°，背伸45°，尺偏30°，桡偏20°，旋前70°，旋后65°。最近1次随访X线片与术前相比，桡骨茎突平均长度自术前6（-10～10）min增加至11（8～14）mln。平均掌倾角自术前-15°（-40°～10°）增加至8°（-5°～15°）。平均尺偏角从12°（-5°～20°）增加至20°（10°～25°）。关节面骨折块平均间距从6（1～18）mm减少至0（0～3）mm。术侧握力为健侧的78％（55％～100％）。根据Gartland与Werley评分标准，优7例，良12例，一般5例，差2例。结论对于累及关节面的粉碎性桡骨远端骨折，T型锁定钢板可以较好地维持骨折复位，允许术后早期功能锻炼，并可获得满意的腕关节功能。
Objective To evaluate the treatment results of open reduction and locking compression plate fixation for comminuted intra-articular fractures of the distal radius. Methods Twenty-six patients of distal radius fractures with a mean age of 61 years were involved in this series. The fractures were classified as AO type-C1 in 8 cases, type-C2 in 12 cases, and type-C3 in 6 cases. 2 of those were open fractures. Two patients had concomitant shoulder dislocation and elbow dislocation respectively. All the fractures were treated with open reduction and locking compression plate fixation in a volar approach. Results Follow-up ranged from 6 to 20 months, the average being 8 months. The mean healing time of the fractures was 8 weeks （6 - 12 weeks） . The mean range of motion of the wrist reached 40° of flexion, 45°of extension, 30° of ulnar deviation, 20° of radial deviation, 70° of pronation, and 65° of supination. X rays taken at last follow-up showed an increase of radial styloid length from preoperative 6 mm （ - 10 mm -10 mm） to 11 mm （8 mm-14 mm）. The volar tilt increased from -15° （-40°- 10°） to 8° （-5°- 15°）. The ulnar inclination increased from 12°（ - 5° - 20°） to 20° （10° - 25°） . The intra-articular step-off decreased from 6mm （ 1 - 18 mm） to 0 mm （0 - 3 mm） . Grip strength was 78% （55% - 100% ） of that of the uninjured side. According to the criteria of Gartland and Werley, the results were excellent in 7 cases, good in 12 cases, fair in 5 cases, poor in 2 cases. Conclusion Locking plate can maintain reduction of the displaced intra-articular fractures of the distal radius. Early movement was allowed, and allowed wrist function can be achieved.
出处
《中华手外科杂志》
CSCD
北大核心
2006年第1期13-15,共3页
Chinese Journal of Hand Surgery
关键词
桡骨骨折
骨折
粉碎性
骨折固定术
内
锁定钢板
Radius fractures
Fractures, comminuted
Fracture fixation,internal
Locking plate
