双柱双接骨板技术治疗伴背侧骨质缺损的C型桡骨远端骨折30例  

Double column double plate tteecchhnniiqquuee used in30 patients with type C distal rraaddiiuuss fractures

作　　者：彭军[1] 周雪峰[1] 白克文[1] 王蒙[1] 鲍磊[1] 

机构地区：[1]解放军306医院骨科全军脊柱外科中心,北京100101

出　　处：《中国骨与关节外科》2015年第4期332-334,309,共4页Chinese Journal of Bone and Joint Surgery

摘　　要：背景：对于背侧骨质缺损的C型桡骨远端骨折的治疗,掌侧入路接骨板固定虽为常用手术方式,但其固定不牢固,临床疗效欠佳,而背侧入路使用双接骨板技术的临床报道较少。目的：探讨使用双接骨板技术治疗背侧骨质缺损的C型桡骨远端骨折的效果。方法：2012年9月至2014年3月,采用背侧入路在桡骨的桡侧柱与中间柱放置两块解剖自锁接骨板治疗背侧皮质缺损的C型桡骨远端骨折30例。男17例,女13例;年龄55~76岁,平均60.5岁。骨折按AO分型：C2型21例,C3型9例。术后定期摄X线片检查复位情况,采用Gartland-Werley评分评估腕关节功能。结果：所有患者均顺利完成手术,手术时间50~70 min,平均60 min。随访时间12~36个月,平均22个月。骨折均获得骨性愈合,腕关节功能恢复良好,目前无与内固定物相关的并发症发生。结论：应用中间柱和桡侧柱双接骨板固定技术治疗背侧骨质缺损的C型桡骨远端骨折是一种固定可靠、临床疗效满意的治疗方法。Background： For the treatment of dorsal type C distal radius fractures with bone defects, volar plate fixation is commonly used. However,the fixation is not firm, and clinical efficacy is poor. Meanwhile, there are few of reports on dorsal approach using double plate technique.Objective： To investigate clinical outcomes of double plate technique for type C distal radius fractures with bone defects.Methods： Thirty patients with type C distal radius fractures with dorsal cortical defects were treated by using two anatomical locking plates between September 2012 and March 2014. The plates were placedon the radialcolumn and the middle column bythe dorsal approach. There were 17 males and 13 females with a mean age of 60.5 years（range, 55-76 years）. According to AO classification, there were 21 patients with type C2 fracture and 9 patients with type C3 fracture. GartlandWerley scoring system was used to evaluate the wrist joint function.Results： The surgery was successfully finished in all patients. The mean operation time was 60 min（range, 50- 70 min）.Bony healing was achieved in all fractures in more than one year follow-up. The wrist function recovered well.Nocomplicationsrelated to platesoccurred until now.Conclusions： Double plate fixation inthe middle column and radial column is a reliable and useful treatment for C type distal radius fractures of dorsal bony defect.

关 键 词：双接骨板 内固定 骨质缺损 桡骨远端骨折 

分 类 号：R687.3[医药卫生—骨科学]