T型钢板加外固定架治疗老年人C3型桡骨远端骨折

Treatment of distal radius fractures of C3 type by T-shaped plate internal fixation combined with external fixation in aged patients

目的探讨T型钢板加外固定架治疗老年人C3型桡骨远端骨折的临床疗效。方法选取2005年4月至2008年6月采用T型钢板加外固定架治疗老年人C3型桡骨远端骨折10例。男6例,女4例;年龄57岁～72岁,平均65岁;左侧5例,右侧5例。术前测量掌倾角和尺偏角,分别为(-40.0±51.0)°和(8.0±3.2)°,术前桡骨短缩为(12.4±5.1)mm,关节面台阶为(4.2±2.0)mm。结果10例患者均获得随访,随访时间6～20月,平均10个月。所有患者均达到解剖复位,骨折愈合时间6～9周,平均7.3周。腕关节功能评分(Gart-land-Werley功能评分):优8例,良1例,差1例。放射学评估采用Sarmiento评分,术后掌倾角和尺偏角分别为(9.3±3.0)°和(18.1±8.1)°,术后未见桡骨短缩;关节面台阶<1mm;这些指标与术前比较差异均有显著性(P<0.01)。所有病例均无感染、内固定松动、骨不连等并发症。结论开放复位T型钢板加外固定架是治疗老年人C3型桡骨远端骨折的有效方法。

【Objective】To investigate the effect of T-shaped plate internal fixation combined with external fixation in the treatment of distal radius fractures of C3 type in aged patients. 【Methods】From April 2005 to June 2008, 10 aged patients with distal radius fractures of C3 type were treated with open reduction and T-shaped plate internal fixation combined with external fixation. The injuries involved 6 males and 4 females, the age of the patients was from 57 to 72 years（average 65 years）.The preoperative ruler and inclination angle were （-40.0 ±51.0）° and （8.0 ± 3.2）°preoperative radial shortened （12.4±5.1） mm and joint surface level （4.2±2.0） mm. [Results] All of the 10 cases were followed lip for 6-20 months （7.3 months on average）. All the fractures were healed, the time to healing was 7.3 weeks. As for the wrist function by GarIland-Werley score, 8 cases were excellent, 1 good, and 1 poor with the choiceness rate of 90.0%. As for radiological assessment by Sanniento, device and palm inclination angles were （9.3±3.0）° and （18.1±8.1）° . No radial shortening was found and joint surface level were less than 1 nun. There was significant difference between pre-operation and post-operation in terms of all indicators postoperatively （P 〈0.01）. No such complications were found as infection, loosing of nails, non-union. [Conclusions] The technique of open reduction and T-type plate and T-shaped plate internal fixation combined with external fixation is an effective method for the treatment of distal radius fractures of C3 type in aged patients.