掌侧入路“L”形钢板内固定治疗桡骨远端Die-punch骨折  

Volar Approach “L”-shaped Locking Plate for Treatment of Distal Radius Die-punch Fractures

作　　者：唐金兵[1] 王庆伟 王华松 丰瑞兵 

机构地区：[1]枣阳市第一人民医院骨科,湖北枣阳441200 [2]解放军武汉总医院骨科

出　　处：《华南国防医学杂志》2017年第12期818-821,共4页Military Medical Journal of South China

摘　　要：目的探讨采用掌侧入路"L"形锁定钢板内固定治疗桡骨远端Die-punch骨折的临床疗效。方法对2012-06/2016-06月在作者医院采用掌侧入路"L"形锁定钢板内固定治疗的21例桡骨远端Die-punch骨折患者病例资料进行回顾性分析,其中男9例,女12例;年龄24~47岁,平均31.7岁;右侧损伤13例,左侧8例。均采用掌侧入路,复位后用桡骨远端"L"形钢板内固定治疗。结果本组21例患者术后获得随访9~23个月,平均13个月,骨折临床愈合时间为2~4个月,平均2.3个月,术后掌倾角9~15°,平均11.6°,尺偏角18~25°,平均22.3°,腕关节掌屈、背伸活动范围89~138°,平均117.4°,腕关节尺偏活动平均32°,桡偏活动平均26°。术后半年随访患腕疼痛,按视觉模拟评分法(visual analogue scale,VAS)评估:0分17例,1分2例,2分1例,3分1例;按照改良Mayo法评价术后患腕功能:优13例,良7例,可1例,总体优良率95.2%。结论采用掌侧入路"L"形锁定钢板内固定可有效治疗桡骨远端Die-punch骨折,能早期恢复解剖形态并牢固固定,便于患肢的早期功能锻炼,术后患者功能恢复良好。Objective To evaluate the clinical effects of＂L＂-shaped locking plate internal fixation in the treatment of distal radius Die-punch fractures.Methods A total of 21 distal radius Die-punch fractures patients who treated by volar approach＂L＂locking plate internal fixation were retrospectively analyzed.There were 9 males and 12 females,aged from 24 to 47（average 31.7）,13 cases of right wrist injury,8 cases of left wrist injury.All cases used volar approach after the reduction with the distal radius＂L＂-shaped locking plate fixation.Results The follow-up lasted for 9-23 months（average 13 months）,all cases showed clinical-healing in2-4 months（average 2.3 months）.Postoperative radial inclination was 9-15°（average 11.6°）,ulnar inclination was 18-25°（average 22.3°）.Wrist palmar flexion,dorsiflexion activity range was 89-138°（average 117.4°）,the average ulnar deviation of wrist joint activity was 32°,radial deviation activity was 26°.The visual analogue scale（VAS）of the wrist pain was followed up for 6 months after operation：0 point in 17 cases,1 point in 2 cases,2 points in 1 case,3 points in 1 case.According to the modified Mayo function evaluation criteria of the wrist：excellent in 13 cases,good in 7,fair in 1 case,and the overall satisfactory were 95.2%.Conclusion Using the volar approach＂L＂-shaped locking plate internal fixation can be effective in the treatment of distal radius Die-punch fractures,which can restore the anatomical shape early and firmly.It is convenient for the early functional exercise of the limb,and the postoperative function is well restored.

关 键 词：桡骨远端骨折 Die-punch骨折 掌侧入路 锁定钢板 内固定 

分 类 号：R683.41[医药卫生—骨科学]