桡侧腕屈肌入路解剖型掌侧锁定接骨板治疗桡骨远端早期陈旧骨折  

The anatomical volar locking plate for treatment of early old distal radius fracture with flexor carpi radialis approach

作　　者：张金明[1] 黄强[2] 安贵生[2] 杨占辉[1] 王伟[1] 王军辉[1] 史宏伟[1] ZHANG Jin-ming;HUANG Qiang;AN Gui-sheng;YANG Zhan-hui;WANG Wei;WANG Jun-hui;SHI Hong-wei(Dept of Orthopaedics,Mentougou District Hospital of Beijing,Mentougou Teaching Hospital,Capital Medical University,Beijing 102300,China;Dept of Traumatic Orthopaedics,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京市门头沟区医院,首都医科大学门头沟教学医院骨科,北京102300 [2]北京积水潭医院创伤骨折,北京100035

出　　处：《临床骨科杂志》2022年第1期82-85,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨桡侧腕屈肌入路解剖型掌侧锁定接骨板治疗桡骨远端早期陈旧骨折的疗效。方法采用桡侧腕屈肌入路解剖型掌侧锁定接骨板治疗19例桡骨远端早期陈旧骨折患者。比较术前和末次随访时桡骨短缩、尺偏角、掌倾角以及腕关节活动度。末次随访时采用Fernandez评分评价腕关节功能。结果患者均获得随访,时间6~12(8.0±1.8)个月。骨折均愈合,时间8~14周。桡骨短缩、尺偏角、掌倾角:末次随访时较术前基本纠正,差异均有统计学意义(P<0.001)。腕关节活动度:掌屈、背伸末次随访时明显高于术前,差异均有统计学意义(P<0.001)。末次随访时,3例主动腕关节屈伸活动后感觉酸胀、疼痛,其余患者基本无酸胀、疼痛感觉;采用Fernandez评分评价腕关节功能:优10例,良6例,可3例,优良率16/19。结论桡侧腕屈肌入路解剖型掌侧锁定接骨板治疗桡骨远端早期陈旧骨折手术入路清楚,术中无桡动脉、桡神经及正中损伤,对矫正骨折短缩、移位及成角安全而且效果满意。Objective To explore the clinical effect of anatomical volar locking plate in the treatment of early old distal radius fracture with the flexor carpi radialis approach.Methods The 19 patients with early old distal radius fractures were treated with anatomical volar locking plate via flexor carpi radialis approach.Radial shorteness,ulnar deviation angle,palmar inclination angle and range of wrist motion were compared between the preoperative and final follow-up,Fernandez score was used to evaluate the wrist function at the last follow-up.Results All patients were followed up for 6~12(8.0±1.8)months.All fractures healed within 8~14 weeks.Radial shorteness,ulnar deviation angle and palmar inclination angle were basically corrected at the last follow-up,compared with the preoperation,with statistical significances(P<0.001).The range of motion of wrist:the palmar flexion and dorsal-extension of the last follow-up were significantly higher than the preoperation,with statistical significances(P<0.001).At the last follow-up,3 patients felt soreness and pain after active wrist flexion and extension activities,and rest patients had no soreness and pain;the wrist function assessed with Fernandez scoring:10 cases were excellent,6 cases good and 3 fair,with an excellent-good rate of 16/19.Conclusions Anatomical volar locking plate with flexor carpai radialis approach for treatment of early old fractures of the distal radius has a clear surgical approach,and there is no injury of radial artery,radial nerve or midline during the operation.It is safe,effective and satisfactory for the correction of fracture shortening,displacement and angulation.

关 键 词：陈旧骨折 桡骨远端骨折 手术入路 

分 类 号：R683.41[医药卫生—骨科学] R689.73[医药卫生—外科学]