背侧入路双钢板技术治疗桡骨远端不稳定骨折

Dorsal dual-plate fixation for unstable distal radius fractures

目的探讨背侧人路双钢板内固定治疗桡骨远端不稳定骨折的临床疗效。方法选择2010年6月-2012年6月背侧入路双钢板治疗桡骨远端骨折患者22例，其中男16例，女6例；年龄22—75岁，平均54．5岁。骨折按AO分型：B2型12例，C1型6例，C2型4例。5例行自体骨或异体骨植骨。结果术后随访5—30个月，平均14个月。采用Gaaland和Wefley功能评估标准评定：优13例，良5例，可4例，优良率为82％。术前掌倾角、尺偏角和桡骨高度分别为（-1．50±7．59）。、（11．90±3．87）。和（5．20±1．55）。，术后分别为（11．07±1．77）°、（22．30±3．13）°和（11．40±1．51）°，术前较术后差异均有统计学意义（P〈0．05）。结论背侧入路双钢板技术治疗AO—B2型掌侧皮质完整的剪力型骨折和背侧严重粉碎的桡骨远端骨折是一种有效可靠的方法。骨缺损时应积极植骨，促进骨愈合。

Objective To evaluate the effect of dorsal dual-plate fixation for unstable distal radius fractures. Methods Twenty-two cases of unstable distal radius fractures undergone dorsal fixation with a 2.4 nun plate from June 2010 to June 2012 were enrolled. There were 16 males and 6 females with mean age of 54.5 years （ range, 22-75 years）. According to the AO fracture classification, there were 12 cases of type B2, 6 type C1 and 4 type C2. Five eases had autologous or allogeneic bone grafting. Results Mean period of follow-up was 14 months （range, 5-30 months）. According to Gartland-Werley score, the result was excellent in 13 cases, good in 5 cases and fair in 4 cases, with the excellent and good rate of 82%. Vo- lar inclination [ （ 11.07±1.77 ）° ], ulnar declination [ （22.30±3.13 ）°], and radial height [ （ 11.40±1.51 ）°] showed statistical differences from that [ （ - 1.50±7.59）°, （ 11.90±3.87 ）°, and （5.20±1.55 ）° respectively] before operation （P 〈 0.05 ）. Conclusions Dorsal dual-plate fixation can be a reliable and effective technique for AO-B2 shear fractures with intact volar-cortex and dorsal critically- comminuted fractures of the distal radius. Active bone grafting should be performed for bone defection to promote bone healing.