掌侧或背侧钢板治疗桡骨远端关节内骨折的疗效比较  

Comparison of volar or dorsal plate in the treatment of intra-articular fractures of distal radius

作　　者：段虹昊[1] 欧学海 郑前进 徐思齐 Duan Honghao;Ou Xuehai;Zheng Qianjin(Ward 1,Hand Center,the Affiliated Honghui Hospital of Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]西安交通大学附属红会医院手外中心一病区,710054

出　　处：《美中国际创伤杂志》2023年第2期6-9,25,共5页U.S.Chinese International Journal of Traumatology

摘　　要：目的:本研究的目的是比较掌侧和背侧钢板治疗桡骨远端关节内骨折的疗效和并发症,特别是背侧钢板的适应症。方法:临床评价指标包括腕关节的活动范围、握力、DASH评分和Gartland-Werley评分。比较使用背侧和掌侧锁定钢板系统的临床结果。根据Lutsky的钢板理论,选择背侧钢板治疗桡骨远端骨折基于4种骨折类型。结果:共有112名患者接受了切复内固定手术,其中背侧入路38例,掌侧入路74例。除了腕关节活动范围,两组患者在其他一些主观和客观参数上均无显著统计学差异。掌侧钢板组和背侧钢板组的并发症发生率无显著统计学差异。掌侧钢板组术后有1例出现严重并发症。选择背侧钢板的最常见原因是不可复位的背侧Die-punch骨折。结论:对于移位的关节内桡骨远端骨折,背侧和掌侧锁定钢板系统固定可以取得同样好的疗效,背侧钢板治疗并没有显著的术后并发症。采用背侧入路更容易处理某些特殊类型骨折。Objective:To compare the efficacy and complications of volar and dorsal plates in the treatment of intra-articular fractures of distal radius,especially the indication of dorsal plate.Methods:Clinical measures included wrist range of motion,grip strength,the Quick disabilities of the arm,shoulder,and hand score(DASH)score,and Gartland-werley score.Clinical results were compared with those achieved using a volarly placed locking plate system.According to Lutsky's plate theory,the rationale for choosing dorsal plating was based on 4 types of distal radius fractures.Results:A total of 112 patients underwent reduction and internal fixation,including 38 cases by the dorsal approach and 74 cases by the volar approach.There were no significant differences in other subjective and objective parameters between the two groups,except for wrist range of motion.There was no significant difference in the incidence of complications between the volar plate group and the dorsal plate group.In volar plate group,1 case had severe postoperative complications.The most common reason for choosing a dorsal plate is non-reducible dorsal Die-punch fracture.Conclusion:For displaced intra-articular fractures of the distal end of the radius,both dorsal and volar locking plate systems are equally effective,there were no significant postoperative complications with the dorsal plate.And it is easier to treat certain types of fractures with a dorsal approach.

关 键 词：桡骨远端骨折 背侧入路 锁定钢板固定 关节内骨折 并发症 

分 类 号：R68[医药卫生—骨科学]