锁定加压钢板内固定治疗中老年女性桡骨远端粉碎性骨折

Treatment of comminuted distal radius fractures of elderly women with locking compression plate

目的探讨锁定加压钢板(LCP)内固定治疗中老年女性桡骨远端粉碎性骨折的疗效。方法自2002年3月～2004年10月,使用LCP治疗中老年女性桡骨远端粉碎性骨折32例35侧,平均年龄65岁。AO分型A3型11侧,C2型15侧,C3型9侧。32侧采用掌侧入路,3侧采用背侧入路;5侧进行植骨。结果所有患者得到随访,随访10～41个月,平均21.5个月。骨折愈合时间3～5个月。按Dienst功能评估标准进行评定:优13侧,良19侧,可2侧,差1侧,优良率为91.4%。伤口延迟愈合及浅表感染5侧,术后正中神经压迫症状2侧。结论LCP内固定治疗桡骨远端粉碎性骨折具有固定可靠、退钉率低、并发症少的优点,特别适合骨质疏松的中老年女性桡骨远端粉碎性骨折的内固定。

Objective To discuss the clinical effects of open reduction and internal fixation with locking compression plate （LCP） to treat elderly women with comminuted distal radius fracture. Methods 32 elderly women （35 sides） with comminuted distal radius fractures were treated by open reduction and internal fixation with LCP from March 2002 to October 2004 in our department. Their mean age was 65 years old. According to AO classification, 11 sides were type A3, 15 sides type C2 and nine sides type C3. Volar approach was used in 32 sides and dorsal approach in three sides. Bone graft was applied for five sides. Results The follow-up period was 10 to 41 months （mean 21.5 months） and the union period was three to five months. According to Dienst criteria of joint functions, the results showed that 13 sides were excellent, 19 sides good, two sides fair and one side poor. Complications included wound dehiscence and superficial infection in five sides and median nerve injury in two sides. Conclusion The LCP method in this study is one of the good options to treat elder women with comminuted distal radius fractures.