掌侧锁定钢板系统用于老年人桡骨远端不稳定骨折治疗中的临床应用研究  

Clinical effect of volar locking compression plate fixation for unstable distal radius fractures in the elders

作　　者：赵红星[1] 董玉珍[1] 

机构地区：[1]新乡医学院第一附属医院骨外科,河南卫辉453100

出　　处：《现代预防医学》2013年第7期1370-1371,1374,共3页Modern Preventive Medicine

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疗效。方法选择2009年5月～2010年5月收治的52例新鲜桡骨远端不稳定骨折老年患者为研究对象,均经腕关节标准正、侧位X线片检查确诊,并根据AO标准分型。随后行掌侧入路骨折切开复位并于掌侧桡骨远端植入掌侧锁定钢板系统进行内固定。术后辅以消肿、抗感染、补充钙剂、主被动功能锻炼等综合治疗。比较手术前后掌倾角、尺偏角、桡骨短缩及关节活动范围,评价腕关节功能恢复情况。结果术前掌倾角、尺偏角分别为(19.4°±10.8°)、(1.6°±3.8°),桡骨短缩(6.6±1.0)mm;术后掌倾角、尺偏角分别为(8.1°±1.6°)、(17.8°±6.0°),桡骨短缩基本纠正。腕关节功能按Dienst标准进行评定:优31例,良18例,可3例,优良率为94.2%。随访期间未发生正中神经炎、腕管综合征、感染、骨不连等并发症。结论切开复位掌侧锁定钢板系统是治疗老年人桡骨远端不稳定骨折安全、有效方法。OBJECTIVE To investigate the clinical effect of volar locking compression plate fixation for unstable distal radius fractures in the elders. METHODS 52 elderly patients with fresh unstable distal radius fractures who diagnosed by standard wrist, lateral X-ray examination from May 2009 to May 2010 were treated by volar fracture open reduction and volar locking compression plate fixation. Swelling, antibiotics, calcium supplementation, exercise and other active and passive functional exercise were taken for postoperative treatment. The effects were evaluated preliminarily by comparing and analyzing the volar tilt, ulnar inclination, radius shortening and wrist function. RESULTS The volar tilt and ulnar inclination were （19.4 ° ± 10.8 °）, （1.6 ° ± 3.8 °） respectively, radius shortening （6.6 ± 1.0） mm before treatment; and the volar tilt and ulnar inclination were respectively （8.1 ° ± 1.6 °） , （17.8 ° ± 6.0 ° ） , and radius shortening was basically corrected. Followed up for 18 months, 31 cases achieved excellent results, 18 cases achieved good results, and 3 cases achieved fair results, according to Dienst standard. The overall satisfactory rate was 94.2%. There were no complications such as median neuritis, carpal tunnel syndrome, nonunion and so on. CONCLUSION Volar locking compression plate fixation is a safe and effective treatment for unstable distal radius fractures in the elders.

关 键 词：骨折 桡骨 骨折固定术 内 掌侧锁定钢板系统 老年人 

分 类 号：R683.41[医药卫生—骨科学]