掌侧2.4mm锁定钢板治疗复杂桡骨远端关节内骨折

2.4 mm volar locking plate in treatment of complex intra-articular fractures of distal radius

目的探讨掌侧2.4 mm锁定钢板治疗复杂桡骨远端关节内骨折的使用方法和疗效。方法从2010年2月至2013年2月本组对新鲜桡骨远端关节内骨折,在伤后两周内使用掌侧2.4 mm锁定加压钢板(或称锁定钢板)进行切开复位内固定手术。随访的病例共48例,男20例,女28例。AO分型:C1型10例,C2型14例,C3型24例。结果在掌倾角、尺偏角,桡骨相对长度与3.5 mm组相比无统计学差异,而关节面平整程度则2.4 mm组优于3.5 mm组,统计学差异有意义。关节的屈伸(96.3°±12.6°)、旋转活动(97.6°±13.8°);握力结果(72.3±10.6)kg。静息时疼痛分级与3.5 mm组比较无统计学差异。活动时疼痛分级及DASH评分2.4 mm组优于3.5 mm组,统计学差异有意义。最终所有骨折均愈合,有3例发生并发症。结论掌侧2.4 mm锁定钢板治疗复杂桡骨远端关节内骨折能有更好的复位质量,从而减少了患者术后活动时的疼痛。并使功能恢复更理想。

Objective To investigate the method and curative effects of using the 2.4 mm volar locking plate （ locking compression plate ） in the treatment of complex intra-articular fractures of the distal radius.Methods 48 patients, including 20 males and 28 females with fresh distal radius fractures were admitted to our hospital from 2010.02 to 2013.02.The 2.4 mm volar locking compression plates were used during the open reduction and internal fixation operations within two weeks .According to AO classification , 10 cases were type C1, 14 cases were type C2, and 24 cases were type C3.Results In the palmar tilt and radial inclination , there was no statistic significance in the relative length of the radius in the 2.4 mm group compared with the 3.5 mm group.While in the number of the cases with smooth joint surface , there was＆amp;nbsp;statistic significance in the 2.4 mm group compared with the 3.5 mm group.The joint flexion was （96.3 °± 12.6 °） , rotation was （ 97.6 °± 13.8°） , and the grip strength was （ 72.3 ±10.6 ） kg.In the visual analogue scale （ VAS ） for the activity pain and the DASH scores , the 2.4 mm group showed statistic significance over the 3.5 mm group.All the fractures were healed including three cases with complications . Conclusion The 2.4 mm locking plate shows better reduction quality in treating the complex intra-articular fractures of the distal radius , which can reduce the postoperative pain and make the recovery much better .