锁定加压钢板内固定联合植骨治疗Barton骨折

Treatment of Barton＇ s fracture with LCP internal fixation combined with bone graft

目的探讨应用锁定加压接骨板（LCP）联合支撑植骨治疗Barton骨折的临床疗效。方法2002年6月-2008年1月，对30例Barton骨折患者，采用切开复位支撑植骨LCP内固定法治疗。术后早期进行合适的康复锻炼。结果术后30例均获得3-24个月的随访，平均12个月。术后X线片显示骨折全部愈合。掌倾角6°～16°，平均10．4°；尺偏角17°～25°，平均20．1°。桡骨纵向无短缩。采用腕关节功能及X线片测量指标进行综合评定：优20例，良8例，差2例；优良率达93．3％。结论应用锁定加压钢板内固定联合支撑植骨治疗Barton骨折，能最大限度地恢复桡骨与尺骨的相对长度、掌倾角及尺偏角，关节面平整。术后配合合理的康复锻炼，能使腕关节功能达到最大的恢复。

Objective To evaluate the clinical outcome of treating Barton＇ s fractures using locking compression plate （LCP） combined with hone graft. Methods Thirty cases of Barton＇ s fracture treated from June 2002 to January 2008 were involved in the study. They were treated with open reduction and internal fixation with LCP combined with bone graft. Early rehabilitation was carried out postoperatively. There were 18 males and 12 females. The mean age of them was 39 years. Results All of the 30 patients were followed up for 3 to 24 months and the average time was 12 months. Bone union was seen in all cases and the average clinical healing time was 8 weeks. The volar tilting angle was 6°to 16°（ average 10.4°） , and the ulnar inclining angle was 17°to 25°（average 20. 1°）. There was no shortening of the radius. Clinical outcome was evaluated hy X-rays and wrist function assessment. The result of 20 cases was graded as excellent, 8 cases as good, and 2 cases as poor. The overall satisfaction rate was 93.3%. Conclusion Surgical treatment using LCP internal fixation combined with bone graft for Barton＇ s fractures can maintain the length of the radius and ulna, restore volar tilting angle and ulnar inclining angle, and achieve good reduction of the articular surface. Early rehabilitation is equally important for the best recovery of wrist function.