微型钢板治疗桡骨远端粉碎性骨折疗效分析

Curative Effeet of Low-profile on Comminuted Fractures of Distal Radius

目的探讨微型钢板在桡骨远端粉碎性骨折治疗中的应用疗效.方法对86例桡骨远端粉碎性骨折患者,分别经腕掌侧(A组)和背侧(B组)入路切开行钢板内固定术.术后随访7～28个月,平均14.1个月.从手术时间、骨折愈合时间、术后早期并发症、术后远期并发症、术后第8、24周腕关节功能恢复等方面比较两组差别.结果参照Gartland和Werley腕关节功能评分,A、B两组术后第24周腕关节功能优良率分别为87.8%和89.1%;放射学评价参照Lidstrom评分,A、B两组桡骨关节面恢复优良率分别为93.2%和91.8%.A、B两组在骨折愈合时间、术后早期并发症、术后第24周腕关节功能恢复等方面差别无显著性(P＞0.05);A、B两组在手术时间、术后远期并发症、术后第8周腕关节功能恢复方面差别有显著性(P＜0.05).结论运用微型钢板内固定治疗桡骨远端粉碎性骨折,能有效重建关节面和关节力线,恢复腕关节功能.

Objective To discuss the curative effect of low - plate on comminuted fractures ot distal radius. Methods Eighty- six cases of comminuted fractures of distal radius were classified into two groups according to the displacement of the distal fragments, and were fixed with the plate volar （Group A） and dorsal approach （Group B） respectively. All the patients were followed up by an average 14.1 months （7-28 months）. The two groups were compared from the following aspects： operative time, lealing time, early complications and the wrist function after 8 and 24 weeks of operation. Results According to Gartland and Werley score, the excellent rates of wrist function in Group A and Group B were 87.8% and 89.1% respctively after 24 weeks of operation. According to Lidstrom radiologieal score, the excellent rates of radial articular surface restore were 93.2 % and 91.8 % respectively. No significant difference was found （P〈0.05） between two groups on healing time, early complications and the wrist function after 24 weeks. The operative time, the latest complications and the wrist function were statistical different betwween two groups affter 8 weeks. Conclusion The application of lowprofile plates in the pratients with comminuted fractures of distal radius can restore the articular surface and mechanical axis.