C型桡骨远端骨折掌侧内固定中接骨板不同位置对疗效影响  

The effect of varying volar plate positioning on the treatment outcomes of internal fixation of type C distal radial fractures

作　　者：王古衡[1] 谢仁国[1] 茅天[1] 邢树国[1] 陈亚兰[2] 李玉周[1] 张宇轩[1] 

机构地区：[1]南通大学附属医院手外科,江苏226001 [2]南通大学医学信息学系

出　　处：《中华手外科杂志》2016年第2期116-119,共4页Chinese Journal of Hand Surgery

基　　金：国家自然科学基金（81071479）;江苏省卫生厅“科教兴卫”工程重点人才基金资助项目（RC2011101）;南通大学自然科学类科研基金项目（132030）;南通大学附属医院院级课题（TDFY0323）

摘　　要：目的 分析比较C型桡骨远端骨折掌侧内固定治疗中,接骨板不同位置（与分水岭间关系）对愈后功能的影响情况.方法 回顾分析我院自2010年4月至2013年4月诊断为桡骨远端骨折C型（AO分型）并接受掌侧内固定治疗的患者53例.研究中根据Soong分级标准在X线侧位片基础之上,将接骨板与桡骨远端分水岭的关系分为0级、1级、2级三个等级,并随访调查.随访内容：影像学参数（Teardrop角、掌倾角、尺倾角、尺骨变异）,腕关节活动度（掌屈、背伸、桡偏、尺偏,旋前、旋后）,手部握力,DASH评分,有无并发症.然后统计分析不同Soong分级组别之间,各测量指标有无差异.结果 随访时间平均21.1个月（12-39个月）,X线片显示所有骨折已愈合,未发现内固定治疗相关并发症,不同Soong分级间各测量指标间差异无统计学意义.结论 本组C型桡骨远端骨折内固定治疗中,接骨板放置不同Soong等级间愈后功能和影像学参数无明显差别,但如有条件接骨板应尽量放置于分水岭以近.Objective To analyze the effect of plate positioning （in relation to the watershed line） on the prognosis of volar internal fixation of type C distal radius fractures.Methods A retrospective review was conducted of 53 patients with type C （AO classification） distal radius fractures treated with internal fixation from April 2010 to April 2013.Based on the standard lateral radiograph,the relationship of the plate and the watershed line was classified as level 0,level 1,and level 2 according to Soong grading system.Radiographic parameters including teardrop angle,volar inclination,ulnar inclination and ulnar variance,wrist motions such as flexion,dorsiflexion,radial deviation,ulnar deviation,pronation and supination,grip strength and DASH scores were used to evaluate the function of the wrist.Postoperative complications were also recorded.These results were compared among patients with different Soong levels.Results These patients had an average of 21.1 months＆#39; follow-up （range,12 to 39 months）.Radiographs showed that all the fractures had healed.There were no complications associated with the internal fixation.No statistically significant differences were seen in the measurements among different Soong levels.Conclusion In treatment of type C distal radius fractures with volar plate internal fixation,position of the plate does not affect the functional recovery and radiographic parameters.However if conditions permit,the plate should be placed proximal to the watershed line.

关 键 词：桡骨骨折 骨折固定术 内 Soong分级 

分 类 号：R687.3[医药卫生—骨科学]