掌侧锁定钢板系统治疗老年人桡骨远端不稳定骨折疗效及切口感染预防  

Effect of Volar Locking Plating System on Treatment of Senile Patients with Unstable Distal Radial Fractures and Prevention of Incision Infection

作　　者：恽常军[1] 钱文杰[1] 朱小国[1] 吴俊义[1] 刘海峰[1] 

机构地区：[1]江苏大学附属武进医院骨科,江苏常州213002

出　　处：《中华医院感染学杂志》2010年第24期3926-3927,共2页Chinese Journal of Nosocomiology

摘　　要：目的探讨掌侧锁定钢板系统治疗老年人桡骨远端不稳定骨折的临床疗效及切口感染的预防措施。方法对31例手法复位失败的老年人桡骨远端不稳定骨折采用切开复位掌侧锁定钢板系统内固定治疗。结果所有患者全部得到随访,随访时间为9~20个月;X线片显示,复位没有丢失,骨折端骨性愈合,关节面台阶〈1 mm,桡骨高度丢失〈2 mm,桡骨远端的掌倾角和尺偏角平均值分别为12.2度和20.4度;根据Gartland和Werley腕关节评分系统,优17例,良10例,优良率达87.1%;31例患者中有2例发生了早期并发症,并发症发生率为6.5%,其中1例为暂时性正中神经鱼际支损伤,另1例为切口部位感染。结论掌侧锁定钢板系统能够为老年人桡骨远端不稳定骨折提供有效的固定,临床疗效较为满意,但应注意围术期的处理,以免发生严重的切口感染。OBJECTIVE To evaluate the therapeutic effect of the volar locking plating system on treating the senile patients with unstable distal radial fractures.METHODS A total of senile patients with unstable distal radial fractures were underwent the open reduction and internal fixation by adopting the volar locking plating system.RESULTS The follow-up time was 9～20 months.Radiographic assessment showed that bone union with no loss of reduction was in all cases.At the final follow-up,intra-articular step-off deformity was less than 1.0 mm and the loss of radius height was less than 2.0 mm.The mean angles of declination of volar distal radius and ulna deviation were 12.2° and 20.4°,respectively.According to the Gartland and Werley system,the results were excellent in 17 cases,good in 10 cases and the rate of excellent and good reached to 87.1%.2 cases with early complications occurred among 31 cases of patients with the incidence rate of 6.5%,of the 2 cases,one was the temporary nerve centre damage and the other was the infection of the incision site.CONCLUSION The volar locking plating system can provide effective fixation for the senile patients with unstable distal radial fractures and achieve a better clinical effect.It should be paid attention to the treatment during the perioperative time to avoid the sever incision infection.

关 键 词：桡骨远端 骨折固定术 老年人 

分 类 号：R181.32[医药卫生—流行病学]