锁定加压钢板内固定结合植骨治疗中老年桡骨远端粉碎性骨折

Internal fixation of locking compression plate （LCP） combined with bone planting in treatment of senile distal radius comminuted fracture

目的探讨锁定加压钢板（LCP）内固定结合植骨治疗中老年桡骨远端粉碎性骨折的疗效。方法自2005年5月-2007年2月，应用LPC结合植骨治疗中老年桡骨远端粉碎性骨折13例，平均年龄64岁。AO分型A3型6例，C2型3例，C3型4例。首先在“C”形臂X线机监视下，通过手法行骨折复位，恢复掌倾角和尺偏角；然后经掌侧入路切口长约5cm。结果所有骨折均得到随访，随访6-25月，平均10个月。骨折愈合时间平均3．5个月。术后无感染、骨不连、钢板松动及正中神经损伤等并发症。1例术后第1d即发生急性腕管综合征，经减张制动后缓解。按Dienst功能评估标准进行评定：优5例，良6例，可2例，优良率84．6％。结论LCP内固定治疗中老年桡骨远端粉碎性骨折具有手术创伤小、固定可靠、退钉率低、并发症少及能早期进行功能锻炼等优点，术中结合一期植骨更有利于骨折愈合，特别适合骨质疏松的中老年桡骨远端粉碎性骨折的治疗。

Objective To Discuss the effect of internal fixation of locking compression plate （LCP） combined with bone plating in treatment of senile distal radius comminuted fracture.Methods From May 2005 to February 2007, 13 senile cases with distal radius comminuted fracture were treated by internal fixation of LCP combined with bone plating, the average of age was 64 years old. AO type： A3 in 6 cases, C2 in 3 cases, C3 in 4 cases. Under the monitor of C size arm of X line machine, manipulation was performed to reset the fractures and recover the inclination of the palm and ulnar.Results All the cases were following-up from 6 to 25 months, and the average was ten months. The average union time of fracture was 3.5 months. And there were no infection, bone disconnection, plate less crowding and median nerve injury.Only one case had acute carpal tunnel syndrome at the first day after the operation, and was improved after decreasing the stretch. Under the Dienst Functional assessment to assess： excellent in 5 cases, good in 6 cases, approve in 2 cases. The superior rate was 84.6%.Conclusion With the small operative wound, the reliable fixation, the low anti-nail rate, the less complication and exercise in early stage, so it is an ideal method to repairing senile radius comminuted fracture by LCP combined with bone plating.