掌侧锁定加压钢板治疗老年桡骨远端不稳定性骨折

Volar locked compression plate fixation of unstable distal radius fractures in the elders

目的:总结锁定加压钢板(LCP)切开复位内固定治疗老年桡骨远端不稳定性骨折的效果。方法:41例老年桡骨远端不稳定性骨折患者,手术行掌侧入路骨折切开复位、LCP内固定治疗。结果:41例患者全部获得随访,随访时间8～19个月,X线片示骨折于术后9～15周达临床愈合,平均12.3周。有3例正中神经损伤,1例术后血肿,1例出现创伤性关节炎,无伤口感染。根据X线片测量,术后掌倾角从6°～14°(平均9.2°);尺偏角从12°到25°(平均18.8°)。根据腕关节功能及X线片测量进行综合评定:优23例,良14例,可2例,差2例,优良率90.2%。结论:LCP可牢固把持骨块,适于早期活动,是治疗老年桡骨远端不稳定性骨折的一种有效方法。

Objective： To study the clinical effect of locked compression plate fixation in the elders with unstable fractures of the distal radius. Methods： 41 cases of unstable distal radius fractures were treated by volar locked compression plate. The function of the carpal joints and the bone healing conditions were evaluated after operations. Results： All cases were followed-up for 8 to 19 months （mean 13. 6 months）. There were no incision infection in all of cases.Three patients reported paresthesia in the area supplied by the cutaneous branch of the median nerve. One patient suffered from haematoma.One patient suffered from traumatic arthritis. Union was obtained in all the patients after 9 to 15 weeks. The clinical outcomes were evaluated according to modified X-rays and wrist assessment. 23 cases were graded as excellent and 14 as good. 2 cases were graded as fair. 2 cases were graded as poor. The overall satisfactory rate was 90.2 One case had traumatic arthritis and 1 case had wrist joint stiffness. All achieved fractures union after 10 to 15 weeks （mean 12.3 weeks） after operations. The the ulnar deviation angle was from 12° to 25° palmar inclinination angle was from 6°to 14° （mean 9. 2°）; （mean 18.8°） after operations. Conclusion： Volar locked compression plate has been proven as a safe and effective implant for treatment of unstable fractures of the distal radius. It is especially suitable for patients with osteoporosis and unstable fractures of the distal radius, in that it can firmly hold the reduced fracture segments and facilitate early postoperative rehabilitation.