摘要
[目的]探讨掌侧入路“T”形锁定加压钢板（T-LCP）治疗桡骨远端背侧不稳定性骨折的初期疗效。[方法]总结2003年9月～2005年11月经掌侧入路T-LCP内固定治疗桡骨远端背侧不稳定性骨折9例。男3例，女6例，年龄52～74岁，平均63．5岁。按AO分类标准：B2型2例，B3型1例，C1型2例，C2型3例，C3型1例，均为闭合性骨折。所有病例均采取掌侧入路，术中不显露背侧组织，骨缺损严重者置入人工骨（Osteoset）。[结果]9例全部获得随访，平均10．7个月（6～17个月）。X线片显示骨折全部Ⅰ期愈合，平均愈合时间为7周。1例骨缺损严重，术中置入人工骨（Osteoset）。所有病例均无感染、骨不连、钢板松动、腕管综合征、正中神经炎等并发症。术后功能康复时间6～29周，平均12．5周。术后第1d开始被动活动腕关节，1周后主动活动，功能锻炼。按改良的Mcbride腕关节功能评价标准：优7例，良1例，可1例，优良率为88．9％。[结论]经掌侧入路T-LCP治疗桡骨远端背侧不稳定骨折，内固定可靠，允许早期功能锻炼，疗效佳。
[ Objective] To evaluate a preliminary outcome of volar surgical treatment of dorsally displaced fractures of distal radius with open reduction and internal fixation with T shape locking compression plate（T-LCP）. [ Method] From Sept. 2003 to Nov. 2005, 9 cases with dorsally unstable distal radius fractures were treated with open reduction and internal fixation with T- LCP. This study involved 3 males and 6 femals with an average age of 63.5 years（ ranged from 52 to 74 years old）. According to AO classification： 2 cases of types B2; 1 case of type B3; 2 cases of type C1 ; 3 cases of type C2; 1 case of type C3, all of them were closed fractures of distal radius. The fractures of 9 cases were fixated with T-LCP by volar approach and dorsal soft tissues were not dissected during the operation. The Osteosets and the artificial bone substitute were implanted into bone defects if they were large enough. [ Result] Nine cases were followed up for 6 to 17 months and the average time was 10.7 months. The X-ray pictures showed that unions have been achieved in all patients and a mean healing time was 7 weeks. The Osteosets were implanted into large bone defects in one case. No complication was found as infection, non-union, loosing of nails, syndrome of wrist, and medium neuritis. The functional recovery was achieved from 6 to 29 weeks with an average time of 12.5 weeks after operation. Passive wrist motion, active finger motion and forearm rotation were encouraged immediately after surgery. Active wrist motion was suggested in 7 days postoperatively. The clinical outcomes were evaluated according to modified Mcbide grading system. There were 7 excellent, 1 good and 1 fair, the satisfactory rate was 88.9%. [ Conclusion] The volar fixation of T-LCP for dorsally displaced fractures of distal radius has a good clinical outcome. It allows the patients to begin early exercise.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2006年第16期1207-1209,共3页
Orthopedic Journal of China
关键词
桡骨远端骨折
内固定
锁定加压钢板
不稳定
distal radius fractures
fracture fixation
locking compression plate
unstable
