掌侧切口和解剖型锁定钛板治疗AO／ASIFC型桡骨远端骨折疗效分析  

Anatomic locking titanium plate fixation via a volar approach in the treatment of AO/ASIF type-Cfractures of the distal radius： an outcomes evaluation

作　　者：王家骐[1] 张鹏[2] 黄祖成[1] 饶志涛[1] 王树青[1] 

机构地区：[1]同济大学附属同济医院骨科,上海200065 [2]复旦大学附属华山医院运动医学科、复旦大学运动医学中心,上海200040

出　　处：《中华手外科杂志》2013年第5期260-262,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨腕关节掌侧切El和解剖型钛板治疗AO／ASIFC型桡骨远端骨折的临床疗效。方法回顾性分析2007年6月至20t1年6月采用腕掌侧切口和解剖型钛板治疗AO／ASIFC型桡骨远端骨折47例，其中C1型17例、c2型2l例、C3型9例，均为闭合性骨折。结果31例患者术后获平均1．5年（1～2．3年）的随访。患者中未发生感染、内固定松动断裂、腕管综合征、肌腱激惹、正中神经损伤等并发症，未见骨延迟愈合和骨不连。术后1年平均掌倾角为（7．5±1．8）°，尺偏角为（19．8±2．7）°。按照改良McBride评价标准评定：优18例，良10例，可3例；优良率为90．3％。结论经掌侧切口解剖型钛板治疗AO／ASIFC型桡骨远端骨折，术后并发症少，有利于早期功能锻炼，是治疗C型桡骨远端骨折的较好方法。Objective To evaluate the treatment outcomes of anatomic locking titanium plate fixation of AO/ASIF type-C fractures of the distal radius via a volar incision at the wrist. Methods A retrospective review was conducted of 47 cases of AO/ASIF type-C fractures of the distal radius treated from June 2007 to June 2011 using pre-shaped anatomic titanium plate fixation via a volar incision. All fractures were closed and according to AO/ASIF classification, there were 17 cases of type C1 fractures, 21 type C2 fractures and 9 type C3 fractures. Results Follow-up was sufficient for 31 patients with an average of 1.5 years （range, 1 to 2.3 years）. The complications such as infection, loosening or breakage of implants, carpal tunnel syndrome, tendon in＇itation and median nerve injury did not ~cur in none of the 31 patients. There was no delayed union or nonunion. At one year postoperatively the average volar inclination angle was （7.5 ±1.8）° while the ulnar deviation angle was （19.8± 2.7）°. According to the modified McBride evaluation criteria, the surgical results were rated as excellent in 18 cases, good in 10 cases and fair in 3 cases. The overall satisfactory rate was 90.3%. Conclusion AO/ASIF type-C fractures of the distal radius can be effectively treated with anatomically pre-shaped titanium plate fixation via a volar approach. The procedure has very few complications and allows early rehabilitation to facilitate hmctianal recovery.

关 键 词：桡骨骨折 骨折固定术 内 手术入路 腕关节 

分 类 号：R687.3[医药卫生—骨科学]