万向双柱锁定接骨板与T型锁定接骨板治疗桡骨远端骨折疗效的比较

Comparison of outcomes between variable angle two-column locking compression plate （LCP） with T-shaped LCP in the treatment of distal radial fractures

目的 比较分析AO 2.4 mm万向双柱锁定接骨板与AO2.4 mmT型锁定接骨板内固定治疗桡骨远端骨折的效果.方法 2011年1月至2013年3月期间在我院治疗的桡骨远端骨折患者50例,其中采用万向双柱锁定加压接骨板治疗20例,T型锁定加压接骨板治疗30例.术后及随访摄片并测量掌倾角、尺偏角和桡骨高度,随访时进行上肢功能评定表（DASH）及腕关节评分（PRWE）,测量腕关节的桡偏、尺偏、掌屈、背伸、旋前、旋后和握力、捏力,并进行统计学分析.结果 术后随访12-24个月,平均15.2个月,两组患者的DASH和PRWE值、腕关节活动度及握力、捏力之间的差异均无统计学意义（P＞0.05）,随访时T型锁定加压接骨板组尺偏角平均值大于万向双柱锁定加压接骨板组,差异有统计学意义（P＜0.05）,其余影像学指标在术后、随访以及变化值两组之间的差异均无统计学意义（P＞0.05）.结论 万向双柱锁定加压接骨板与T型锁定加压接骨板治疗桡骨远端骨折有相似的疗效.

Objective To compare the results of treating distal radius fractures by open reduction and internal fixation （ORIF） with AO 2.4 mm variable angle two-column locking compression plate （LCP） and with AO 2.4 mm T-shaped LCP.Methods Clinical data of 50 cases with distal radius fractures treated from January 2011 to March 2013 were analyzed.Among them 20 fractures were treated with ORIF with the variable angle two-column LCP,whereas 30 fractures were treated with ORIF with the T-shaped LCP.Postoperative follow-up and evaluations included measurement of volar tilt,radial inchnation and radial height in posteroanterior and lateral views of the wrist,Disabilities of the Arm,Shoulder and Hand （DASH） score,and patient related wrist evaluation （PRWE） questionnaires,ulnar deviation/radial deviation and flexion/extension of the wrist,supination/pronation of the forearm,and the grip and pinch strength.Statistic analysis was done to compare measurements from the two groups.Results Postoperative follow-up duration ranged from 12 to 24 months,with an average of 15.2 months.There were no significant differences between the two groups in terms of DASH and PRWE scores,the values of the range of motion and grip and pinch strength （P 〉 0.05）.The mean radial inclination in the T-shaped LCP group was bigger than that in the variable angle two-column LCP group.The difference was statistically significant （P 〈 0.05）.The other radiographic parameters were not significantly different between the two groups.Conclusion Both variable angle two-column LCP and T-shaped LCP lead to comparable treatment outcomes when used for fixation of distal radius fractures.