解剖型桡骨掌侧锁定接骨板固定术治疗不稳定性桡骨远端骨折的疗效  

Curative efficacy of unstable distal radius fracture treated by anatomic volar locking plate

作　　者：纪斌[1] 曹成福[1] 成翔宇[1] 唐桐生[1] 樊海峰[1] 庞金辉[1] 

机构地区：[1]上海中医药大学附属普陀医院骨科,上海200062

出　　处：《上海医学》2013年第6期552-555,I0002,共5页Shanghai Medical Journal

基　　金：上海市重点建设学科项目(T0303);上海市卫生局科研项目(2010164)资助

摘　　要：目的探讨解剖型桡骨掌侧锁定接骨板固定术治疗不稳定性桡骨远端骨折的疗效。方法 2010年7月—2012年6月,上海中医院大学附属普陀医院共收治67例不稳定性桡骨远端骨折患者,根据Müller AO分型,A3型11例、B2型4例、B3型2例、C1型15例、C2型23例、C3型12例。所有患者均采用切开复位后行解剖型桡骨掌侧锁定接骨板内固定术,术后定期随访。术后6个月采用Stewart改良的Sarmiento系统和Dienst标准对骨折复位情况和患腕关节功能进行评估。结果所有患者均获随访,随访时间6～18个月,平均随访时间为(12.6±3.2)个月。X线片显示所有骨折均愈合,平均愈合时间为(8.7±2.4)周。术后6个月,经X线片测量桡骨茎突高度为(10.3±2.1)mm、掌倾角为(8.5±4.2)°、尺偏角为(21.1±4.9)°,均基本恢复正常;采用Stewart改良的Sarmiento系统评估显示复位优良率为95.5%(64/67),采用Dienst标准评估患侧腕关节功能的优良率为92.5%(62/67)。结论采用切开复位后行解剖型桡骨掌侧锁定接骨板内固定术治疗不稳定性桡骨远端骨折可获得较理想的疗效。Objective To evaluate the radiologic and functional outcomes of internal fixation for unstable distal radius fractures with anatomic volar locking plate. Methods From July 2010 to June 2012, 67 patients underwent open reduction and internal fixation with anatomic volar locking plate. These comminuted distal radius fractures included 11 type A3, 4 type B2, 2 type B3, 15 type C1, 23 type 02, and 12 type C3, according to the AO/ASIF classification. Fracture reduction and wrist joint function were assessed by Sarmiento criteria modified by Stewart and Dienst scale at 6 months after operation. Results All patients were followed up for （12. 6 ±3.2） months （range, 6±18 months）. X-ray showed that all fractures were healed after （8.7±2.4） weeks. The average height of radial malleolus was （10.3±2.1 ） mm, the volar inclined angel was （8.5±4.2）°, and the ulnar deviation was （21. 1± 4. 9）° at 6 months after surgery. The results were excellent and good in 64 patients （95.5%） by Sarmiento criteria and in 62 patients （92.5%） by Dienst scale for wrist joint function. Conclusion Open reduction and internal fixation with anatomic volar locking plate is an effective method for unstable distal radius fractures.

关 键 词：桡骨远端骨折 骨折内固定 锁定接骨板 

分 类 号：R687.3[医药卫生—骨科学]