固定角度掌侧接骨板结合克氏针治疗不稳定桡骨远端骨折

Treatment of unstable fractures of distal radius by fixed-angle volar plates combined with Kirschner-wires

目的探讨固定角度掌侧接骨板结合克氏针治疗不稳定桡骨远端骨折的临床效果。方法2005年1月至2007年12月对19例不稳定桡骨远端骨折采用切开复位固定角度掌侧接骨板结合克氏针固定治疗，随访临床效果。结果所有患者随访5～14个月，平均11个月，所有患者均骨性愈合，愈合时间5～16周，平均愈合时间9．6周。掌倾角5°～12°，平均9．4°；尺偏角18°～24°，平均21°。6例轻度疼痛，4例活动受限，平均屈伸角度12°，平均握力为健侧的84．2％，桡骨长度得到恢复，关节面台阶〈1mm。Cooney腕关节评分：优4例，良13例，可2例，优良率89．5％。结论固定角度掌侧接骨板结合克氏针固定治疗不稳定桡骨远端骨折，可以获得满意的临床效果。

Objective To summarize our experience of treating unstable fractures of distal radius by fixed-angle volar plates combined with Kirschner-wires, Methods Nineteen patients with unstable fractures of distal radius were treated by fixed-angle volar plate fixation combined with Kirschner-wires, They were followed up for wrist motion evaluation and radiographic examination, Results All cases were followed up for 5 to 14 （mean, 11 ） months. All fractures healed within 5 to 16 weeks. Their volar tilt angles ranged 5° to 12° and radial inclination 18° to 24°, Six cases reported slight pain and 4 cases limited motion. According to the Cooney rating scale, 4 cases were excellent, 13 cases good and 2 cases fair. Conclusion Fixed-angle volar plating combined with Kirschner-wiring can achieve satisfactory effects in treatment of un- stable fractures of distal radius.