桡骨远端骨折掌侧锁定钢板固定时检测背侧螺钉穿出透视方法的研究与进展  

Research and development of fluoroscopy for the detection of dorsal screw penetration in the fixation of distal radius fracture with volar locking plate

作　　者：王皓楠 温树正[2] 王继宏[2] 郝增涛[2] 樊东升[2] 景尚斐[2] 韩超前[2] 王永飞[2] 王小龙[2] 殷超[2] 姜东 Wang Haonan;Wen Shuzheng;Wang Jihong;Hao Zengtao;Fan Dongsheng;Jing Shangfei;Han Chaoqian;Wang Yongfei;Wang Xiaolong;Yin Chao;Jiang Dong(Inner Mongolia Medical University,Hohhot 010030,Inner Mongolia Autonomous Region,China;Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010030,Inner Mongolia Autonomous Region,China)

机构地区：[1]内蒙古医科大学,内蒙古自治区呼和浩特市010030 [2]内蒙古医科大学第二附属医院,内蒙古自治区呼和浩特市010030

出　　处：《中国组织工程研究》2020年第12期1957-1961,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:尽管桡骨远端骨折掌侧锁定钢板内固定治疗后所引发的桡骨远端腕背侧伸肌腱的激惹、磨损及断裂发生率不高,但这类并发症却严重影响着患者的生活质量。目的:总结掌侧锁定钢板固定桡骨远端骨折时术中透视方法的最新进展。方法:以英文“volar locking plate,distal radius fracture,radiological method”为检索词,应用计算机在PubMed数据库检索2000至2019年的相关文献共160篇;以中文“透视方法,桡骨远端骨折,掌侧接骨板”为检索词,应用计算机在万方数据库检索2000至2019年的相关文献共7篇。对掌侧锁定钢板固定桡骨远端骨折时术中透视方法的相关文献进行综述。结果与结论:①桡骨远端骨折应用掌侧锁定钢板进行内固定时术中透视方法多种多样,例如标准正、侧位方法、腕管位透视法、“天际线”方法、背侧切线视图及径向凹槽视图等;②上述常用方法在检测掌侧锁定钢板内固定后背侧螺钉穿出问题仍具有一定局限性,所造成的腕背侧伸肌腱激惹、磨损及断裂等并发症仍有发生,二次及多次手术给患者生活及经济等方面带来的问题也应当引起重视;③应该找到更为恰当的术中检测方法,以期能够降低因掌侧锁定钢板内固定后背侧螺钉穿出所引发的并发症发生率。BACKGROUND:Although the incidence of irritation,abrasion and rupture of the extensor tendon at the dorsal carpal side of the distal radius caused by internal fixation with volar locking plate is not high,these complications seriously affect the quality of life of the patients.OBJECTIVE:To summarize the latest progress of intraoperative fluoroscopy in the treatment of distal radius fracture with volar locking plate.METHODS:Using the English key words“volar locking plate,distal radius fracture,radiological method”,the authors retrieved PubMed for 160 relevant studies published from 2000 to 2019.Using the Chinese key words“fluoroscopy,distal radius fracture,volar plate”,the authors searched Wanfang database for 7 relevant studies published from 2000 to 2019.This paper reviewed the literature of intraoperative fluoroscopy in the treatment of distal radius fracture with volar locking plate.RESULTS AND CONCLUSION:(1)There are various methods of intraoperative fluoroscopy during volar locking plate fixation for distal radius fracture,such as standard anteroposterior view,lateral view,carpal canal method,skyline,dorsal tangent view and radial groove view.(2)The above common methods still have some limitations in detecting the problem of posterior screw penetration in volar locking plate fixation.The complications such as irritation,abrasion and rupture of the extensor tendon of the dorsal wrist still occur,and the problems brought by the secondary and multiple operations to the patients’life and economy should also be paid attention to.(3)More appropriate intraoperative detection methods should be found,in order to reduce the incidence of complications caused by the internal fixation of the posterior screw with the locking plate on the palmar side.

关 键 词：桡骨远端骨折 掌侧锁定钢板 内固定 透视方法 并发症 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]