支垫钉技术结合锁定钢板治疗桡骨远端背侧不稳定骨折

The Comparative Study of the Support Stud Technique Combined with LCP Fixation for the Treatment of Dorsal Inter-articular Distal Radial Fracture

目的通过分组比较研究,观察一种支垫钉技术结合锁定钢板在治疗背侧不稳定桡骨远端关节内骨折的疗效。方法 2008年12月至2013年2月,我科进行的所有背侧不稳定桡骨远端骨折手术治疗共107例,其中仅应用掌侧锁定钢板治疗（A组）59例,应用掌侧锁定钢板结合支垫钉技术治疗（B组）48例。随访两组患者术后掌倾角、尺偏角及Dienst功能评分等,比较两种手术方法在治疗背侧不稳定桡骨远端骨折中的疗效。结果两组患者随访时间8～21个月,随访以完成内固定取出手术为两组手术方法终点,平均14个月。术后X线片示骨折均愈合,钢板螺钉无松动断裂。两组患者掌倾角、尺偏角得到明显改善,B组患者掌倾角改变更明显,且差异有统计学意义,尺偏角改善两组相似,差异无统计学意义,术后Dienst功能评估疗效,两组无明显差异,均取得了满意的疗效。结论支垫钉技术在桡骨远端背侧不稳定骨折的治疗中对有效恢复掌倾角存在积极意义,结合锁定钢板可牢固维持复位,有利于患肢腕关节功能恢复。

Objective To by compare study,observed the clinical curative effect of support stud technique combined with Volar LCP fixation for the treatment of dorsal inter-articular distal radial fracture. Methods From December 2008 to February 2013,107 patients were divided into two groups： Only applications LCP in the treatment group（ A group,59 cases）,the application of LCP combined with support stud group（ B group,48 cases）. We followed-up the patients,analysed the palmar tilt,ulnar inclination and Dienst function score,evaluated the advantage of the support stud technology combined Volar LCP in the treatment of dorsal inter-articular distal radial fracture. Results All the patients were followed up form 8 to 21 months（ average 14 months）. Postoperative X-ray showed all the fracture healed,no plate and screw broken and loosening. Patients palmar tilt,ulnar inclination had been significantly improved in both groth. There had significant improvement of group B patients with palmar tilt. Ulnar inclination improvement in the two groups was no significant difference. All patients＇ Dienst score had no significant differences and achieved satisfactory results. Conclusion The support stud technique combined with Volar LCP fixation is a safe and effective method for treat of the unstable distal radial fracture. It is more helpful for replacing,recovering the tilt and early functional.