经旋前方肌下置入LCP内固定治疗桡骨远端骨折  

The treatment of distal radius fractures of by LCP internal fixation implanted under pronator quadratus

作　　者：刘红军[1] 明立功[2] 明立德[2] 明立山[2] 明朝戈[2] 

机构地区：[1]洛阳市中心医院 手外科,河南 洛阳471000 [2]河南省滑县骨科医院 手外科,河南 安阳456485

出　　处：《实用手外科杂志》2014年第2期174-175,182,共3页Journal of Practical Hand Surgery

摘　　要：目的：探讨经旋前方肌下置入LCP内固定治疗桡骨远端骨折的方法及临床效果。方法2008年4月-2011年1月，采用掌侧入路保留旋前方肌的方法，于旋前方肌下置入LCP内固定治疗桡骨远端不稳定骨折17例，按AO分类标准：B1型2例，B2型7例，B3型2例，C1型4例，C2型2例。所有病例均采取掌侧入路，术中不切断旋前方肌，或仅切断部分旋前方肌行旋前方肌下置入LCP内固定治疗桡骨远端骨折。结果本组术后随访9～44个月，平均13个月。骨折全部一期愈合，平均愈合时间7周。均无感染、骨不连、腕管综合征等并发症。按改良的Mcbride腕关节功能评价标准评定：优15例，良1例，可1例，优良率94.1%。结论经旋前方肌下置入LCP内固定治疗桡骨远端骨折，是完全可行的，符合现代微创手术的观点。旋前方肌能够覆盖接骨板大部分，减少了腕部肌腱的干扰，减少组织损伤，最大程度地保留前臂的旋转功能，有利于腕关节功能的恢复。Objective To evaluate the clinical effect and method of LCP internal fixation for the treatment of fractures of the distal radius under the pronator quadratus. Methods From April 2008 to January 2001, by the volar approach with reservation of pronator, the unstable distal radius fractures were treated by LCP internal fixation inserted under the pronator quadratus in 17 cases, according to AO classification： type B1 2 cases, type B2 7 cases, type B3 2 cases, type C1 in 4 cases, 2 cases of C2 type. All the cases were taken by volar approach, pronator quadratus were reserved, or only to cut off partly and LCP internal fixation were inserted under pronator to treat distal radius fractures. Results The patients were followed up for 9~44 months, with the average of 13 months. All fracture healed, the average healing time was 7 weeks. No infection, nonunion, carpal tunnel syndrome and other complications occurred. According to the improved Mcbride wrist joint function evaluation standard： excellent in 15 cases, good in 1 case, moderate in 1 case, the excellent and good rate was 94.1%. Conclusion The LCP internal fixation inserted under the pronator quadratus for treatment of distal fractures is completely feasible, in line with the point of view of modern minimally invasive operation. Pronator can cover the plate, reduces interference of wrist tendon, reduce tissue injury, to maximize the retention of forearm rotation function, is advantageous to the recovery of wrist function.

关 键 词：桡骨远端骨折 掌侧入路 内固定 旋前方肌 

分 类 号：R683.41[医药卫生—骨科学]