有限接触加压钢板与锁定加压钢板治疗前臂骨折的前瞻性随机对照研究  

Prospective,randomized trial study on comparison of the limited contact dynamic compression plate with locked compression plate for forearm fractures

作　　者：黄华伟[1] 黄勇全[1] 陈文明[1] 方毅[1] 廖强[1] 胡芯源 吴锋[1] 

机构地区：[1]江西萍乡市人民医院骨科,江西萍乡337000

出　　处：《中国现代医学杂志》2011年第11期1422-1424,1428,共4页China Journal of Modern Medicine

摘　　要：目的验证锁定加压钢板在治疗前臂骨干骨折中较有限接触动力加压钢板有更好的结果。方法 91例患者(144例前臂骨折)随机分成锁定加压钢板与有限接触加压钢板两治疗组。患者平均年龄34岁,平均随访期22个月。所有患者定期采用影像评估,疼痛及功能以最后随访结果为准。结果锁定加压钢板组3例患者(4例骨折)、有限接触加压钢板组5例患者(5例骨折)出现延迟愈合,两组中无不愈合患者。就目前数字而言,两治疗组间手术时间、骨折愈合时间、骨痂量、疼痛及功能均差异无统计学意义。深部感染分别出现于锁定加压钢板组内一闭合性骨折及有限接触加压钢板组内一开放性骨折患者。螺钉从尺骨拔出见于有限接触加压钢板组内一开放性尺桡骨折老年患者。此外,锁定加压钢板组内一患者内植物取出术后锁钉钉道出现再骨折。结论尽管骨折固定理念不同,两内植物在前臂骨干骨折治疗中显示相似的效果。【Objective】To test the hypothesis that use of the locked compression plate（LCP） device for the treatment of diaphyseal fractures of the forearm create additional benefit as compared with use of the limited contact dynamic compression plate（LC-DCP） device.【Methods】Ninety-one patients with 144 forearm fractures were recruited for the study and were randomly assigned to fracture fixation with one of the two devices.The average age of the patients was thirty-six years.The average duration of follow-up was twenty-two months.Patients were assessed periodically with use of radiographs and were assessed with regard to pain and function at time of the latest follow-up.【Results】Three patients（four fractures） in the LCP group and five patients（five fractures） in the LC-DCP group had a delayed union,but no patient in either group had a nonunion.With the numbers available,there was no significant difference between the two groups with regard to operative time,time to union,callus formation,pain,or functional outcome.Deep infection occurred in one patient with a closed fracture in the LCP group and in one patient with an open fracture in the LC-DCP group.Pulling out of screws from the ulna were noted at three months postoperatively in an old man with open fractures of the radius and ulna that had been treated with LC-DCP device.In addition,one re-fracture occurred at the site of a screw track in LCP group.【Conclusion】Despite the differences in the con-cept of fracture fixation,these two implants appear to be equally effective for the treatment of diaphyseal forearm fractures.

关 键 词：前臂骨干骨折 锁定加压钢板 有限接触动力加压钢板 前瞻性随机对照研究 

分 类 号：R683[医药卫生—骨科学]