掌、背侧微型钢板联合固定治疗桡骨远端粉碎性骨折  

Treatment of comminuted fracture of distal radius with combined fixation of volar and dorsal microplates

作　　者：张盼 赵庆华[1] ZHANG Pan;ZHAO Qing-hua(SectionⅠ,Dept of Orthopaedics,the People′s Hospital of Huaibei City,Huaibei,Anhui 235000,China)

机构地区：[1]淮北市人民医院骨一科,安徽淮北235000

出　　处：《临床骨科杂志》2024年第3期386-389,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨掌、背侧微型钢板联合固定治疗桡骨远端粉碎性骨折的疗效。方法采用掌、背侧微型钢板联合固定治疗20例桡骨远端粉碎性骨折。记录骨折复位情况、术后并发症发生情况、骨折愈合情况、腕关节活动度、影像学检查指标(掌倾角、尺偏角、桡骨高度)。采用DASH评分和Mayo评分评价腕关节功能恢复情况。结果患者均获得随访,时间7~12(9.0±1.3)个月。骨折均解剖复位。术后无切口感染、肌腱断裂、重度神经损伤及骨折复位丢失、继发移位、骨不愈合等并发症发生。骨折均愈合,时间9~14(10.8±1.5)周。末次随访时,腕关节活动度:桡屈患侧小于健侧(P<0.05),背屈、掌屈、尺屈患侧与健侧比较差异均无统计学意义(P>0.05);影像学检查指标:患侧与健侧比较差异均无统计学意义(P>0.05)。末次随访时,DASH评分2~34(10.2±9.6)分;Mayo评分64~98(85.4±12.7)分,优良率16/20。结论掌、背侧微型钢板联合固定治疗桡骨远端粉碎性骨折,能获得满意的骨折复位及稳定的内固定效果,患者能早期进行腕关节锻炼,更利于腕关节功能恢复,且并发症发生率低。Objective To investigate the effect of combined fixation of volar and dorsal microplates in the treatment of comminuted fracture of distal radius.Methods The 20 cases of comminuted distal radius fractures were treated with volar and dorsal microplates combined fixation.Fracture reduction,postoperative complications,fracture healing,range of wrist activity and imaging indicators(palmar tilt angle,unlar inclination angle and radial height)were recorded.The recovery of wrist joint function was evaluated by DASH score and Mayo score.Results All the cases were followed up for 7~12(9.0±1.3)months.All fractures were anatomically reduced.There were no postoperative complications such as incision infection,tendon rupture,severe nerve injury,loss of fracture reduction,secondary displacement and nonunion.All the fractures healed in 9~14(10.8±1.5)weeks.At the last follow-up,the wrist range of motion:the radial flexion of the affected side was smaller than that of the healthy side(P<0.05);there were no statistical differences in dorsiflexion,palmarflexion and ulnar flexion between two sides(P>0.05).There were no statistical differences in imaging indicators between the affected side and healthy side(P>0.05).At the last follow-up,DASH scores were 2~34(10.2±9.6)points;Mayo scores were 64~98(85.4±12.7)points,and the excellent-good rate was 16/20.Conclusions In treating comminuted fracture of distal radius,combined volar and dorsal microplates fixation can obtain satisfactory fracture reduction and stable internal fixation effect.Patients can exercise the wrist joint early,which is more conducive to the recovery of the wrist joint function,and the complication incidence rate is low.

关 键 词：桡骨远端骨折 微型钢板 掌、背侧 

分 类 号：R683.41[医药卫生—骨科学] R687.32[医药卫生—外科学]