桡骨远端不稳定骨折手术治疗的功能评价  

Effects of internal fixation with plate on unstable distal radius fracture

作　　者：宋文慧[1] 周劲松[1] 侯喜君[1] 

机构地区：[1]解放军总医院骨科,北京100853

出　　处：《山西医科大学学报》2006年第6期648-650,共3页Journal of Shanxi Medical University

摘　　要：目的回顾性分析切开复位钢板内固定治疗桡骨远端不稳定骨折的临床疗效及其对治疗效果的影响并评价应用内固定的价值。方法根据桡骨远端不稳定骨折的特点,就AO分型为B型和C型的桡骨远端不稳定骨折20例行切开复位,按AO内固定原则并根据桡骨的解剖外形,使用解剖钢板或锁定加压钢板(LCP)内固定治疗。对于骨质破坏严重,骨缺损的病例,通过植入自体骨或异体骨来恢复支撑。结果全部病例采取切开复位,获得满意的畸形矫正。手术后3 d进行功能锻炼。术后随访6-10个月时,腕关节的活动度:掌屈为(54±11)°,背屈为(61±10)°。腕关节功能采用DASH肩臂手功能标准和PRWE功能指标进行综合评定,并使用患者主观评价。其中优17例,良3例,总优良率为100%。结论采用切开复位解剖钢板或锁定加压钢板治疗桡骨远端不稳定骨折术中副损伤少,血运破坏小。可以早期进行功能锻炼。临床疗效确切,患者自我满意度高。部分干骺端骨缺损的病例可以同时植骨恢复桡骨的长度和关节面的解剖形状。Objective To evaluate the clinical and functional outcome of patients with displaced and unstable fracture of the distal radius treated with open reduction and internal fixation. Methods Twenty patients with unstable fracture of the distal radius （Types B and C according to AO） were treated using metal plates and screws. Wrist function was assessed by the DASH and PRWE critera. The patients＇ subjective assessment was also performed. Results All cases were followed up for 5 to 15 months and the average time was 8 months. Patients had an average 61° of dorsiflexion and 54° of palmarflexion at the wrist. According to criterion of patients, subjective assessment： 18 cases excellent, 2 cases good. Conclusion Unstable distal radius fracture can be reliably and anatomically reduced and stabilized using internal fixation. Fixation of markedly comminuted fracture is secure enough to allow immediate motion. Preliminary clinical and radiographic results are excellent, and patient satisfaction is high. Bone allograft is especially suitable for the patients with large bone absence of distal radius.

关 键 词：桡骨骨折 骨折固手术 内 治疗效果 

分 类 号：R683.41[医药卫生—骨科学]