锁定加压钢板在中青年桡骨远端关节内粉碎性骨折中的应用

Locking Plate Fixation in the Treatment of Comminuted Distal Radius Fracture in Young and Middle -Aged Patients

目的探讨中青年桡骨远端骨折的临床特点,及锁定加压钢板在桡骨远端关节内粉碎性骨折中的应用效果。方法2008年2月到2010年6月,对25例桡骨远端关节内粉碎性骨折患者（20~50岁）进行切开复位LCP内固定,术后早期功能锻炼。结果25例患者均获得随访,随访6~20个月,平均12个月。所有患者掌倾角、尺偏角、桡骨短缩程度、关节面台阶等均得到整复,骨折平均愈合时间为44 d,术后6周时腕关节活动度达到正常的80%以上。术后并发腕管综合征1例,无肌腱炎及肌腱断裂,无创伤性关节炎。最终疗效根据Dienst腕关节功能评估标准进行评定：优22例,良2例,可1例。结论中青年桡骨远端关节内粉碎性骨折常为高能量损伤,多为不稳定骨折,早期切开复位LCP内固定可获得较满意的临床疗效。

Objective To investigate the clinical features of distal radius fracture and the surgical outcomes of locking compression plate（LCP） in the treatment of comminuted distal radius fracture in young and middle-aged patients.Methods From February 2008 to June 2010,25 patients with comminuted distal radius fractures（20-50 years old） underwent the operation of open reduction and internal fixation with LCP,and early functional exercise were carried out.Results All the patients were followed up for 6-20 months（mean 12 months）.Bone healing was obtained in all the patients with essentially normal Volar tilt,radial inclination,radial length and articular surface.The mean healing period was 44 days.The wrist activity achieved more than 80% of the normal 6 months after operation.One patient supervened with carpal tunnel syndrome,and no other complications were observed such as tendonitis,tendon rupture and traumatic arthritis.These clinical outcomes were evaluated according to Dienst grading： 13 patients were graded as excellent,3 were good and 1 was fair.Conclusion The distal radius fracture in young and middle-aged patients that usually resulted from the high-energy injury are mainly unstable fractures.Early open reduction and internal fixation with LCP could lead to satisfied clinical outcomes.