掌侧锁定钢板加横向克氏针内固定治疗桡尺远侧关节失稳型桡骨远端骨折

Volar locking plate and transverse Kirschner wire fixation for treatment of distal radius fractures with unstable distal radioulnar joint

目的 探讨采用掌侧锁定钢板加横向克氏针内固定治疗桡尺远侧关节失稳型桡骨远端骨折的临床疗效.方法 回顾性分析自2008年至2012年间就诊的桡骨远端骨折合并桡尺远侧关节损伤患者58例61侧患腕,其中掌侧锁定钢板加横向克氏针内固定组28侧,掌侧锁定钢板内固定组33侧.采用Gartland和Werley评分系统进行疗效评价,并分析其原因.结果 术后随访4～ 36个月,平均21.5个月,掌侧锁定钢板加横向克氏针组优良率92.86％,掌侧钢板内固定组优良率87.88％.结论 桡尺远侧关节失稳型桡骨远端骨折运用掌侧锁定钢板加横向克氏针内固定能有效减轻术后腕关节功能障碍.

Objective To investigate the clinical effects of combined volar locking plate and transverse Kirschner wire fixation for treatment of distal radius fractures with unstable distal radioulnar joint （DRUJ）.Methods A retrospective study was conducted to review 58 cases of 61 injured wrists with DRUJ instability and distal radius fractures treated between 2008 and 2012.Among them 28 wrists were treated with volar locking plate combined with transverse Kirschner wire fixation.The other 33 wrists were treated with volar locking plate fixation only.Garfland and Werley grading systems were used for postoperative evaluations.The causes of the clinical outcomes were analyzed.Results Postoperative follow-up period ranged from 4 to 36 months with an average of 21.5 months.The results were rated good in 92.86 % of patients treated with combined volar locking plate and transverse Kirschner wire fixation and in 87.88 % of those treated with volar locking plate fixation only.Conclusion Volar locking plate combined with transverse Kirschner wire fixation can effectively treat distal radius fractures with DRUJ instability and alleviate postoperative functional impairment of the wrist joint.