T型锁定加压钢板内固定治疗桡骨远端骨折合并干骺端及骨干粉碎性骨折  

Clinical efficacy of T-Locking compression plate internal fixation for the treatment of distal radius fractures with metaphyseal and diaphyseal comminution

作　　者：李杰[1] 庄颜峰[1] 魏梅洋[1] 

机构地区：[1]南京军区福州总医院骨二科,350000

出　　处：《临床外科杂志》2014年第1期58-60,共3页Journal of Clinical Surgery

摘　　要：目的 探讨掌侧入路T型锁定加压钢板内固定治疗桡骨远端骨折合并干骺端及骨干粉碎性骨折的临床疗效.方法 采用掌侧入路T型锁定加压钢板内固定治疗桡骨远端骨折合并干骺端及骨干粉碎性骨折40例,均采用经掌侧入路,骨缺损严重者置入人工骨.结果 所有患者均获随访,平均25个月（12～45个月）,骨折平均愈合时间16周（10～28周）.根据Gratland-Werley功能评估标准进行评定：优32例,良5例,中2例,差1例,优良率达92.5%.1例患者术后出现正中神经麻痹,但3个月后自愈,1例患者出现下尺桡关节炎,2例患者出现关节间隙轻度狭窄,但无腕关节功能障碍,未见骨感染、骨分离、内固定松动等并发症.结论 掌侧入路T型锁定加压钢板内固定治疗桡骨远端骨折合并干骺端及骨干粉碎性骨折的疗效确切,它可提供较好的轴向和角度稳定性并具有整体固定特点,有利于术后早期有效的功能锻炼,降低术后并发症的发生率.Objective To assess the clinical efficacy of T-locking compression plate （T-LCP）in- ternal fixation for distal radius fractures with metaphyseal and diaphyseal comminution. Methods Fourty patients underwent T-LCP internal fixation for distal radial fractures with metaphyseal and diaphyseal com- minution. All surgeries were performed through a volar approach. Patients with severe bone defects were implanted with artificial bones. Results All the patients were followed up for 25 months （ range, 12-45 months）. The average time to fracture union was 16 weeks（ range, 10-28 weeks）. According to the Gart- land-Werley demerit point scoring system ,32 results were rated as excellent ,5 as good ,2 as fair, and 1 as bad. The overall satisfactory rate was 92.5%. One patient had paresthesia in the median nerve distribution without motor deficit. This symptom resolved spontaneously after 3 months ; one patient showed distal radio- ulnar joint arthritis ;2 wrists showed mild arthritic changes without restriction in daily activities;no patients showed infections, separation, internal fixation loosening and other complications. Conclusion T-LCP in- ternal fixation through volar approach is useful in the management of distal radius fractures with metaphy- seal and diaphyseal comminution. It provides good stability in axes and angles with total fixation, which benefits the early functional exercises and minimize the postoperative complications.

关 键 词：桡骨远端骨折 掌侧入路 T型锁定加压钢板 内固定术 

分 类 号：R681[医药卫生—骨科学]