掌侧接骨板治疗桡骨远端Die—punch骨折疗效分析  

Outcomes analysis of treatment of die-punch fractures of the distal radius with volar plate fixation

作　　者：王古衡[1] 谢仁国[1] 茅天[1] 邢树国[1] 高以峰 陈亚兰[2] 潘张军 

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 [3]宜兴市人民医院手外科

出　　处：《中华手外科杂志》2016年第3期214-216,共3页Chinese Journal of Hand Surgery

基　　金：国家自然科学基金（81371948）;江苏省卫生厅“科教兴卫”工程再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）;南通市科技项目（MS22015120）

摘　　要：目的评估掌侧接骨板治疗桡骨远端Die—punch骨折的治疗效果。方法自2011年2月至2013年6月，我们采用掌侧接骨板治疗桡骨远端Die—punch骨折患者23例。Die—punch骨折根据骨折块位置分为三型：背侧型、掌侧型和纵向劈裂型。接骨板选择2．4mm T型接骨板或万向双柱锁定加压接骨板。术后早期行指间关节和掌指关节主动活动，4周后行腕关节康复训练。随访内容包括摄X线片、腕关节活动度、握力、DASH评分及有无腕部畸形或相关并发症。分析不同类型Die—punch骨折间及不同接骨板治疗组间随访结果的差异。结果术后23例均获得随访，时间为13～41个月，平均22．8个月。X线片结果显示骨折愈合，关节面平整。未发现腕部畸形及其他并发症。不同类型Die—punch骨折及不同接骨板治疗组间随访结果比较显示，腕关节活动度、握力及DASH评分差异均无统计学意义。结论掌侧内固定治疗桡骨远端Die—ptmch骨折疗效满意。Objective To evaluate the clinical outcomes of treating die-punch fractures of the distal radius with volar plate fixation. Methods From February 2011 to June 2013, 23 patients with distal radial die-punch fractures were treated with open reduction and volar plate fixation. Based on the different locations of fracture fragments, the die-punch fractures were divided into 3 types： dorsal type, volar type and longitudinal split type. A 2.4 mm T-type plate or 2.4 mm variable angle two-column locking compression plate was used via a FCR approach. Metacarpophalangeal joint and interphalangeal joint movement started early postoperatively. Wrist rehabilitation was initiated 4 weeks after the surgery. Follow-up evaluations included X-rays, wrist range of motion, grip strength and DASH score. Wrist deformity or complications were also recorded. These evaluation parameters were compared among different fracture types or between two plate types. Results All the 23 patients had sufficient follow-up for an average of 22.8 months （range, 13 to 41 months）. Radiographs showed that the fi＇acture shad healed and the articular surface was smooth. There were no wrist deformity and other complications. There were no significant differences in wrist motion, grip strength and DASH score among different types of fracture fragments and types of plates. Conclusion The efficacy of volar plate fixation for distal radial die-punch fractures is satisfactory.

关 键 词：桡骨骨折 骨折固定术 内 Die—punch骨折 

分 类 号：R687.3[医药卫生—骨科学]