跨腕关节钢板治疗桡骨远端粉碎骨折  

Transarticular fixation with plate comminuted distal radius fractures

作　　者：郭勇[1] 林旭[1] 黄迅[1] 谭伦[1] 钟泽莅[1] 

机构地区：[1]四川省自贡市第四人民医院骨科,四川自贡643000

出　　处：《生物骨科材料与临床研究》2010年第3期11-14,共4页Orthopaedic Biomechanics Materials and Clinical Study

基　　金：四川省卫生厅科学研究项目(070003)

摘　　要：目的探讨跨腕关节钢板在治疗桡骨远端粉碎骨折中的应用及临床治疗效果。方法 2007年3月～2008年10月采用跨腕关节钢板治疗桡骨远端粉碎骨折16例。男11例,女5例。年龄21～56岁,平均40.3岁。按AO分类,C2型4例,C3型12例。采用背侧跨腕关节钢板固定的方法治疗桡骨远端粉碎骨折。从掌倾角、尺偏角、桡骨茎突长度、关节面台阶方面对桡骨远端影像学进行评估。采用Jakim评分对腕关节功能进行评估。结果所有患者均获得随访,随访时间12～18个月,平均14.3月。掌倾角由术前-10.69°±19.43°改善至术后8.125°±4.72°,尺偏角由术前7.125°±9.025°改善至术后20.500°±4.097°,桡骨茎突长度由术前(4.731±3.597)mm改善至术后(11.931±1.514)mm,关节面台阶由术前(4.294±1.594)mm改善至术后(0.563±0.550)mm。根据Jakim评分标准,优7例,良6例,可1例,差2例。结论跨腕关节钢板治疗桡骨远端粉碎骨折,特别是累及干骺端和骨干的桡骨远端粉碎骨折时,是一种较为有效的方法 。Objective To evaluate outcome of the treatment of comminuted distal radial fractures using a transanticular plate.Method From March 2007 to October 2008,16 cases（11 men,5 women） with comminuted distal radius fractures were treated with dorsal transanticular plate.Their average age was 40.3 years（21-56 years）.All the fractures were classified with AO-scheme.There were four C2-fractures twelve C3-fractures.The effects were evaluated through comparing the volar tilt,radial inclination,the length of styloid process ofradius,articular set-off.The function of the wrist was evaluated by Jakim scale.Result All patients were followed up（mean 14.3 months,range 12-18 months）.The volar tilt increased from-10.69°±19.43°to 8.125°±4.72°,radial inclination increased from 7.125°±9.025°to 20.500°±4.097°,the length of styloid process ofradius increased from（4.731±3.597）mm to（11.931±1.514）mm,articular set-off decreased from（4.294±1.594）mmto（0.563±0.550）mm。The last,therewere 7excellenet,6good,1 fairand2 pooraccordingto the Jakim scale.Conclusion The use of a transarticular plate can be an effective technique for treatment of fractures of the distal end of the radius with extensive metaphyseal and diaphyseal comminution.

关 键 词：钢板 桡骨远端骨折 

分 类 号：R687.3[医药卫生—骨科学]