固定角度掌侧钢板治疗桡骨远端不稳定骨折术后早期并发症分析  

Analysis of early complications in unstable distal radius fractures treated with fixed angle volar plate

作　　者：李宏志[1] 宋秀峰[1] 郑加法[1] 周锦明[1] 关盛溢[1] 

机构地区：[1]大连市第二人民医院手足外科,大连116001

出　　处：《骨科临床与研究杂志》2017年第1期6-10,共5页Journal Of Clinical Orthopedics And Research

摘　　要：目的探讨固定角度掌侧钢板治疗桡骨远端不稳定骨折术后早期并发症的原因和预防措施。方法回顾总结2011年3月至2014年6月采用固定角度掌侧钢板治疗的桡骨远端不稳定骨折患者资料,男41例,女104例;平均年龄56.2岁(21~86岁)。其中合并糖尿病32例,合并心血管系统疾病42例,合并精神分裂症1例。桡骨远端骨折按照AO分型:A3型44例,C1型22例,C2型27例,C3型52例。在第2~14个月最终随访时确定功能评分,5例有并发症需要手术治疗的患者,在二次手术前记录功能评分。功能评价采用Cooney评分。结果在术后1,2,4和6周时随访,对功能练习进展不顺利的患者随访至术后8~12周,对5例有并发症需要手术治疗的患者随访至术后。对63例患者随访超过12个月。本组随访患者145例,除1例夏克关节患者愈合差,其余患者均骨性愈合。经Cooney评分评定:优89例,良34例,可13例,差9例。优良率84.8%。出现9种62例术后并发症,涉及49例患者,术后并发症发生率为33.8%。结论采用固定角度掌侧钢板治疗桡骨远端不稳定骨折可以获得良好的结果,但出现一定比例的术后早期并发症,应引起重视。Objective lb explore the reasons and preventive measures of the early complications in unstable distal radius fractures treated with fixed angle volar plate. Methods The data of patients with unstable distal radius fractures treated with fixed angle volar plate from March 2011 to June 2014 were collected retro-spectively, which included 41 males and 104 females, with the average age of 56.2 years （range,21 to 86 years） old. There were 32 cases with diabetes, 42 cases with cardiovascular disease, 1 case with schizophrenia. According to AO classification, there were 44 cases of A3 type, 22 cases of Cl type, 27 cases of C2 type, 52 cases of C3 type. The functional status were assessed with Cooney score system at the final follow-up within 2 - 14 months, which of 5 cases with complications requiring surgical treatment were recorded before the recisional operation. Results All the patients were routinely reviewed at 1,2,4 and 6 weeks postoperatively. The pa-tients whose functional recovery progressed unsmoothly were followed up to 8 - 12 weeks after surgery. Five pa-tients with complications requiring surgical treatment were continuously followed up after the second surgery. Sixty-three patients were followed up for more than 12 months. All the fractures archieved bony healing, except 1 case with Charcot arthropathy. According to Cooney score, excellent function were obtained in 89 cases, good in 34 cases, medium in 13 cases, poor in 9 cases. The excellent and good rate was 84. 8% . There were 62 ca-ses of complications involved 49 patients, which could be categorized into 9 sorts. The complication rate was 33. 8%. Conclusion Reasonable good clinical outcome can be expected in unstable distal radius fractures treated with fixed angle volar plate. A certain percentage of early complications should be emphasized.

关 键 词：桡骨骨折 骨折固定术 内 手术后并发症 固定角度钢板 

分 类 号：R687.32[医药卫生—骨科学]