掌侧锁定加压接骨板治疗老年桡骨远端关节内骨折

Volar locking compression plating fixation for intra-articular distal radial fractures in elderly patients

目的评价锁定加压接骨板治疗老年桡骨远端关节内骨折的疗效。方法对22例老年桡骨远端关节内骨折,按照AO分类标准:B1型3例;B2型7例;C1型7例;C2型4例;C3型1例,采用掌侧入路锁定加压接骨板内固定进行手术治疗。通过对患者术后X线片观察、腕关节功能随访等分析,评价该方法的疗效。结果22例全部获得随访,平均15个月,X线片显示骨折全部一期愈合,平均愈合时间为12周。X线测量尺偏角平均20.8°,掌倾角平均8.5°,桡骨茎突较尺骨茎突平均长1.0cm;1例桡骨远端较术后早期X线片缩短0.2cm。根据改良的Mcbride腕关节功能评价标准,优16例,良5例,可1例,优良率95.7%。未发现其它严重并发症。结论老年桡骨远端关节内骨折采用掌侧入路锁定加压接骨板,是一种有效的治疗方法。

Objective To evaluate the effects of treatment for intra - articular distal radial fractures in elderly patients with volar locking compression plating fixation. Methods Thirty old patients who suffered from the severe intra - articular distal radial fractures were treated with volar locking compression plating fixation. In this group all the fractures were classified according to AO classification：3 of type B1,7 of type B2,7 of type Cl,d of type C2 and 1 of typeC3. The results of treatment were evaluated by comparing pre - and post - operative observations and X - ray of in- volved wrists. Results The 22 cases were followed up for an average time of 15 months. The X -ray pictures showed that one -stage union was achieved in all the pictures ,with a mean healing time of 12 weeks. Their clinical outcomes were evaluated according to modified Mcbride grading system. 16 were rated as excellnt,5 as good and 1 as fair, with the good and excellnt rate being 95.7%. These data were improved postoperatively to the average radial inclination of 20. 8 degree, palmar tilt of 8.5 degree and the radial lngth 1.0 cm longer between the ulnar head and the tip of the radial styloid. The radial lngth was found 0.2 cm shorter in cases in the latest follow - up than that measured before. No severe complications were found in this group. Conclusions Volar locking compression plating fixation is one of the effective treatments for intra - articular distal radial fractures in elderly natlents.