摘要
目的探讨锁定加压钢板治疗桡骨远端关节内骨折的初期疗效。方法总结2003年4月-2006年11月锁定加压钢板内固定治疗桡骨远端关节内骨折23例，均为闭合性骨折。所有病例均采用掌侧入路，骨缺损严重者置人异体骨。术后功能康复时间6—27周，平均11．2周。结果23例术后x线片提示骨折均一期愈合，平均愈合时间为7．2周；腕关节活动度平均为：掌屈71．3°，背伸69．1°，尺偏25．2°，桡偏19．5°，旋前80．2°，旋后79．7°。所有病例均无感染、钉板松动断裂、腕管综合征、关节炎及正中神经炎等并发症。按改良的Mcbride腕关节功能评价标准：优14例，良8例，可1例，优良率为95．7％。结论锁定加压钢板治疗桡骨远端关节内骨折，能较好地维持骨折复位，同时允许术后早期功能锻炼，减少了因长期固定而导致的骨量丢失，可获得满意的腕关节功能。
Objective To evaluate the preliminary outcome of treatment of intraarticular distal radius fractures by locking compression plate. Methods From April 2003 to November 2006, 23 patients （ 10 males and 13 females, aged 27 - 81 years, mean 54 years） with intraarticular distal radius fracture were treated with locking compression plate. According to AO classification, 2 cases belonged to type B2, 7 to type B3, 2 to type C1,9 to type C2, and 3 to type C3. Every patient was fixed through the volar approach. All of them were closed fractures. Heterogeneous bone was implanted in, those with large bone defect. The postoperative functional recovery lasted from 6 to 27 weeks with an average of 11.2 weeks. Passive wrist motion, active finger motion and forearm rotation were encouraged immediately after surgery. Active wrist motion was enconraged seven days postoperation. Results All the 23 cases were followed up for 6 to 30 months,with an average time of 19.7 months. The X - ray pictures showed that bone union by first intention was achieved in all the patients, with a mean healing time of 7.2 weeks. No infection or non - union was found. The mean range of motion of the wrist reached 71.3°of flexion, 69. 1° of extension, 25.2°of ulnar deviation, 19.5°of radial deviation, 80.2° of pronation, and 79.7°of supination. No such complications were found as infection, nonunion, loosened nails, carpal tunnel syndrome, arthritis or median neuritis. According to the modified Mcbride grading system, 14 were rated as excellent, 8 as good and 1 as fair, with their good - excellent rate being 95.7%. Conclusions LCP can ensure a good fixation in the treatment of intra - articular distal radius fractares and early exercise was allowed. It reduces the quantity of bone lose caused by long - term fixation, and achieves satisfactory wrist function.
出处
《武警医学》
CAS
2009年第2期149-152,共4页
Medical Journal of the Chinese People's Armed Police Force
