掌侧T型锁定钢板联合桡骨茎突钢板治疗C型桡骨远端骨折  

TREATMENT OF TYPE C FRACTURES OF THE DISTAL RADIUS WITH VOLAR LOCKING COMPRESSION PLATE AND RADIAL STYLOID PROCESS PLATE

作　　者：张俊[1] 尹伟忠[1] 沈燕国[1] 丁菊红[1] 秦惠敏[1] 曹师锋[1] 胡晓亮[1] 

机构地区：[1]上海市浦东新区人民医院骨科,上海201299

出　　处：《中国修复重建外科杂志》2012年第11期1281-1284,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨掌侧T型锁定钢板联合桡骨茎突钢板治疗C型桡骨远端骨折的疗效。方法 2010年5月-2011年5月,采用掌侧T型锁定钢板联合桡骨茎突钢板内固定治疗C型桡骨远端骨折24例。男8例,女16例;年龄23～73岁,平均52岁。摔伤20例,交通事故伤4例。左侧15例,右侧9例。均为新鲜闭合骨折。根据AO分型:C2型16例,C3型8例。术前掌倾角—60～25°,平均—45.3°;尺偏角—16～13°,平均8.2°;桡骨短缩8～18 mm,平均12 mm。伤后至手术时间3～10 d,平均5.2 d。结果术后切口均Ⅰ期愈合。24例均获随访,随访时间9～16个月,平均13.5个月。X线片示骨折均愈合,愈合时间8～12周,平均10.2周。关节面平整,桡骨长度恢复。掌倾角8～15°,平均12.3°;尺偏角18～26°,平均22.3°。随访期间未发生复位丢失、原骨折部位再骨折、腕管综合征等并发症。末次随访时患者腕关节活动范围:背伸30～70°,平均45.3°;掌屈26～78°,平均50.2°;桡偏8～25°,平均13.5°;尺偏15～32°,平均23.6°;旋前35～90°,平均65.7°;旋后20～90°,平均72.5°。腕关节功能按照Gartland-Werley评分方法评定:获优12例,良8例,中4例;优良率83.3%。结论掌侧T型锁定钢板联合桡骨茎突钢板内固定可重建正常解剖结构,临床效果良好,是治疗C型桡骨远端骨折的有效方法之一。Objective To analyze the e ectiveness of volar locking compression plate（LCP） and radial styloid process plate for the treatment of type C fractures of the distal radius.Methods Between May 2010 and May 2011,24 cases of type C fractures of the distal radius were treated,including 8 males and 16 females with an average age of 52 years（range,23-73 years）.Injury was caused by falling in 20 cases and by tra c accident in 4 cases.All were fresh closed fractures.The locations were the left side in 15 cases and the right side in 9 cases.According to AO typing,there were 16 cases of type C2 and 8 cases of type C3.The preoperative palmar tilt angle ranged from—60 to 25°（mean,—45.3°）;the preoperative ulnar inclination angle ranged from —16 to 13°（mean,8.2°）;and the preoperative radial length shortening was 8-18 mm（mean,12 mm）.The time from injury to operation was 3-10 days（mean,5.2 days）.Results All operation incisions healed primarily.All patients were followed up 9-16 months（mean,13.5 months）.The healing time of fracture was 8-12 weeks（mean,10.2 weeks）.The articular surface was smooth and the radial length was recovered.The postoperative palmar tilt angle ranged from 8 to 15°（mean,12.3°）;the postoperative ulnar inclination angle ranged from 18 to 26°（mean,22.3°）.No loss of reduction,refracture,or carpal tunnel syndrome occurred during follow-up.The average range of motion of the wrist was 45.3°（range,30-70°） in dorsal extension,was 50.2°（range,26-78°） in palmar exion,was 13.5°（range,8-25°） in radial inclination,was 23.6°（range,15-32°） in ulnar inclination,was 65.7°（range,35-90°） in pronation,and was 72.5°（range,20-90°） in supination at last follow-up.According to the wrist function by Gartland-Werley scoring,the results were excellent in 12 cases,good in 8 cases,and fair in 4 cases;and the excellent and good rate was 83.3%.Conclusion Treatment of type C fractures of the distal radius with volar LCP and radial styloid process plate c

关 键 词：桡骨远端骨折 锁定钢板 内固定 

分 类 号：R687.3[医药卫生—骨科学]