摘要
目的探讨桡背侧双锁定钢板治疗桡骨远端骨折的临床疗效。方法2007年3月至2009年12月采用桡骨侧双锁定钢板治疗22例桡骨远端不稳定骨折患者，男12例，女10例；平均年龄47．5岁（21～78岁）。骨折AO分型：A3型1例；B2型5例；C1型2例，C2型11例，C3型3例。其中5例术中采用自体髂骨植骨。术后评价包括影像学测量尺偏角、掌倾角及桡骨高度．关节活动范围，握力测量，肩臂手功能丧失量表（DASH）评分，以及Garlland—Werley量表评分。结果22例患行术后获平均19个月（12～32个月）随访。所有患者骨折均在术后6个月内（2～6个月）获愈合。影像学测量尺偏角平均为25．3°（22°～29°），掌倾角平均为12．1°（8°～14°），桡骨高度平均为1．1cm（0．8～1．3cm）。Stewart改良评分的优良率为90．9％．关节活动范围：背伸平均为53°（30°～68°），掌屈平均为47°（32°～65°），尺偏平均为22°（16°～30°），桡偏平均为14°（11°～32°），旋前平均为76°（30°～90°），旋后平均为72°（10°～90°）。以健侧为参学，术侧握力平均为72％（15kg）。DASH评分平均为I1．4分（0～70分），Gartland—Werley量表评分平均为3．4分（1～16分）．结论桡肯侧双锁定钢板治疗桡骨远端不稳定骨折临床疗效较好，尤其是对于背侧皮质粉碎严重的患者，能够为骨折提供更加牢固的支撑。
Objective To evaluate clinical results of double dorsal Ioeking plates used in the fixation of distal radial fractures. Methods From March 2007 to December 2009, 22 patients with distal radial fractures were fixed with double dorsal anatomical locking plates. They were 12 males and 10 females, with a mean age of 47. 5 years （21 to 78 years）. By AO classification, there were one ease of type A3, 5 cases of type B2, 2 cases of type C1, 11 cases of type C2 and 3 cases of type C3. lilac autografi was performed in 5 palients. Clinical resuhs and pnstoperalive functional recovery were assessed by range of motion, grip strength, radiographic measurements of ulnar iucliuation, pahnar tilt and radial height, the DASH （Disabilities of the Arm, Shnuhter and Hand） questinnnaire and the Gartland-Werley scale. Results The mean fldlow-up was 19 months （12 to 32 months）. All fractures united within 6 months （2 to 6 months）. The mean ulnar inclination angle wax 25.3° （22°to 29°）, the mean palmar tilt angle was 12. 1° （8° to 14°）, and the mean radial heighl was 1.1 cm （0.8 to l. 3 era） . The mean radiographic Stewart score was excellent or fine in 90. 9% of the palienis. The mean dorsal extension was 53° （30° to 68°）, the mean palmer flexion was 47° （32° to 65°）, the mean ulnar inclination was 22° （16° to 30°）, the mean radial inclination was 14° （11° to 32°）, the mean pronation was 76°（30° to 90°） amt the mean supination was 72° （ 10° to 90°）. The mean grip strength of the operated side was 72% （15 kg） of the uormal side. The mean Q-DASH and Gart- land-Werley scores were I I. 4 （0 In 70） amt 3.4 （1 to 16）, respectively. Conclusions Fixation with dnuhle dorsal locking plates for unstable distal radial fracture.s can result in fine clinical results, especially for those with comminuted dorsal bone cortex.
出处
《中华创伤骨科杂志》
CAS
CSCD
2011年第3期230-233,共4页
Chinese Journal of Orthopaedic Trauma
关键词
桡骨骨折
骨折固定术
内
骨板
Radius fractures
Fracture fixation, internal
Bone plates
