桡骨远端不稳定骨折掌背侧不同入路钢板内固定疗效对比  

Comparison between volar and dorsal plate positions in the treatment of unstable fracture of distal radius.

作　　者：董建军[1] 彭伟[2] 

机构地区：[1]锡林浩特市人民医院,内蒙古锡林浩特026000 [2]北京解放军309医院

出　　处：《健康大视野（医学版）》2013年第8期710-711,共2页Health Horizon:Medical Science Fascicule

摘　　要：目的比较掌背侧不同手术入路及不同内固定钢板治疗桡骨远端不稳定骨折的疗效。方法回顾性分析2008年1月-2011年12月，收治桡骨远端骨折患者47例，男25例，女22例；年龄34～68岁，平均53．7岁。交通伤15例，跌伤32例。随机分为两组，分别经腕掌侧（A组，n=27）及背侧（B组，n=20）入路切开行钢板内固定术。根据植入的内固定钢板不同将A、B两组分为A1、A2及B1、B2亚组，（1为普通T型支撑钢板），（2为锁定钢板）。其中A113例，A214例，B19例，B21l例。结果47例患者均获随访，随访时间6～24个月，平均13个月。A组愈合时间为（8．2±1．6）周，B组为（8．7±1．2）周，比较差异无统计学意义（P〉0．05）。腕关节功能采用Cartland-Wedey评分，术后12周A组优12例，良10例，差5例，优良率为81．4％；B组优7例，良8例，差5例，优良率为75％；两组比较差异有统计学意义（P〈0．01）。结论掌背侧不同手术入路可为桡骨远端不稳定骨折提供有效复位。使用普通T型钢板经掌侧入路术后并发症少，使用锁定钢板掌侧入路同背侧入路术后功能恢复无明显差异。Objective To compare the differences between volar and dorsal plate positions in the treatment of unstable fracture of distal radius. Methods From January 2008 to December 2011,47 eases with fracture of distal radius were treated,25 males and 22 females, aged 34-68 years （ 53.7 years on average ） , among which 15 cases were caused by traffic accidents and 32 cases falls. All the cases were randomized into 2 groups： the wrist palmar group （ group A, n=27 ） and dorsal group （ group B, n=20 ）, to perform volar and dorsal plate fixation, respectively. According to different type of plate the group A were divided into two groups： AI and A2, and the group B into two groups：B1 andB2.（groupl ：T-buttressplate） , （group2： loekingplate）.Results All ofthe 47 cases were followed up for 6-24 months （ 13 months on average ）. The time to healing in group A was （ 8.2 ± 1.6 ）weeks, and in group B was（ 8.7 ± 1.2 ）weeks, and the difference was not significant（ P〉0.05 ）. As for the wrist function by Cartland-Werley scoring at the 12th week after operation, 12 cases were excellent, 10 good, and 5 poor in group A with the choiceness rate of 81.4%, while 7 cases were excellent, 8 good and5 poor in group B with the choiceness rate of 75%. There was significant difference between the two groups （ P〈0.01 ） .Conclusions The volar and dorsal plate positions may offer effective stability for unstable distal radial fracture and early functional exercise. The volar plate position may influence the pronation function of the wrist joint in the short run, while the dorsal plate position may cause more complications in the long run.

关 键 词：桡骨远端骨折 手术入路 钢板内固定 

分 类 号：R683.41[医药卫生—骨科学]