摘要
目的通过分析AO掌侧锁定加压接骨板（locking compression plate，LCP）治疗桡骨远端骨折的随访结果，探讨影响掌侧LCP治疗桡骨远端骨折疗效的因素。方法对2004年7月-2007年10月，在我科采用AO掌侧LCP治疗的55例桡骨远端骨折患者进行随访。随访内容包括测量腕关节运动范围及握力，应用Gartland／Wedey腕关节评分法和DASH上肢功能评定标准进行评分。结果55例患者获得6-44个月的随访（平均17．3个月），骨折均愈合。疗效按Gartland／Wedey腕关节评分：优32例，良10例，可12例，差1例，优良率76．4％；DASH上肢功能评定得分为[（9．34±13．8）分，牙±s，下同]。≤55岁组DASH评分为（9．2±15．6）分，Gartland／Wertey腕关节评分为（3．8±5．2）；〉55岁组DASH评分为（9．44±11．2）分，Gartland／Werley腕关节评分为（4．8±5．1）；两组间差异无统计学意义（P〉0．05）。单纯桡骨远端骨折组DASH评分为（4．9±6．4）分，Gartland／Wedey腕关节评分为（2．74±3．8）；伴有尺侧损伤或严重局部软组织损伤组DASH评分为（14．1±18．0）分，Gartland／Werley腕关节评分为（5．9±6．0）；两组间差异有统计学意义（P〈0．05）。结论AO掌侧LCP治疗桡骨远端骨折的固定效果好，配合适当的术后功能锻炼，可取得良好的疗效。采用AO掌侧LCP作内固定在≤55岁和〉55岁两个年龄组中腕关节功能恢复相近，而伴有尺侧损伤或严重局部软组织损伤者功能恢复较差。
Objective To analyze the influencing factors for the treatment results of distal radius fracture by AO volar locking compression plate （LCP） fixation. Methods In the period from July 2004 to October 2007, 55 cases of distal radius fractures were treated with volar locking compression plate in our center. Clinical outcomes were evaluated by active range of motion of the wrist and forearm, grip strength, Gartland/Werley wrist scoring systems and the Disabilities of the Arm, Shoulder, and Hand （DASH） questionnaire. Results There were 55 patients who were followed up for 6 to 44 months, with an average of 17.3 months. All the fractures healed. The Gartland/Werley scores were excellent in 32 eases, good in 10, fair in 12, and poor in 1. The excellent and good rate was 76.4%. The average DASH score was 9.3 ±13.8. Patients younger than 55 years had DASH scores of 9.2 ± 15.6 and Gartland/Wedey scores of 3.8 ±5.2, while patients older than 55 years had DASH scores of 9.4 ± 11.2 and Gartland/Werley scores of 4.8 ± 5.1. The differences between the two age groups were not statistically significant （ P 〉 0.05）. Patients with simple distal radius fractures had DASH scores of 4.9 ± 6.4 and Gartland/Werley scores of 2.7 ± 3.8, while those suffered accompanying ulnar side injury or severe soft tissue injuries had DASH scores of 14.1 ± 18.0 and Garfland/Wedey scores of 5.9 ± 6.0, the differences being significant （P 〈 0.05 ）. Condusion The AO volar locking compression plate fixation provides solid fixation to the fractures. Supplemented with appropriate postoperative training satisfactory results can be achieved. Similar functional outcomes were seen in patients younger or older than 55 years. Patients with ulnar side injury or severe soft tissue injuries appear to have worse results.
出处
《中华手外科杂志》
CSCD
北大核心
2009年第5期279-282,共4页
Chinese Journal of Hand Surgery
基金
教育部优秀青年教师基金
江苏省手外科临床医学中心建设基金
江苏省“135工程”重点学科科研课题基金资助项目（SK2002-21）
关键词
桡骨骨折
骨折固定术
内
功能评价
Rradius fractures
Fracture fixation, internal
Functional assessment
