背侧入路微型锁定钢板内固定治疗桡骨远端背侧不稳定骨折

Treatment of dorsal unstable distal radius fractures with mini locking plate internal fixation through a dorsal approach

目的 探讨背侧入路微型锁定钢板内固定治疗桡骨远端背侧不稳定骨折的方法及疗效.方法 2012年3月至2013年10月对15例桡骨远端背侧不稳定骨折患者通过背侧入路切开复位,微型锁定钢板内固定治疗,其中男9例,女6例;年龄35 - 72岁,平均41.5岁.骨折AO分型：B3型1例,C2型12例,C3型2例.术后早期功能锻炼,X线片评估骨折复位,腕关节功能评分.结果 术后随访时间6- 18个月,按照Gartland和Werley评价系统评估腕关节功能：优13例,良2例.良2例均是腕掌屈缺陷＜30°伴偶尔疼痛.结论 对于桡骨远端背侧不稳定骨折,通过良好的背侧显露,微型锁定钢板可有效完成复位和固定并支持早期功能锻炼.

Objective To investigate the treatment methods and outcomes of dorsal unstable distal radius fractures with mini locking plate internal fixation through a dorsal approach.Methods From March 2012 to October 2013,15 cases of dorsal unstable distal radius fractures were treated with open reduction and internal fixation （ORIF） with mini locking plate through a dorsal approach.There were 9 males and 6 females.Their ages ranged from 35 to 72 years,with average of 41.5 years.By AO classification,there were one case of type B3,12 cases of type C2 and 2 cases of type C3.All these cases performed early postoperative rehabilitation.Regular X-ray examination was done to assess fracture reduction and bone union.The Gartland-Werley scoring system was used to evaluate wrist function.Results Postoperative follow-up ranged from 6 to 18 months.Wrist function was rated excellent in 13 cases and good in 2 cases according to Gartland-Werley scoring system.The 2 cases rated as good had less than 30° flexion lag and occasional pain.Conclusion For treatment of dorsal unstable distal radius fractures a good dorsal exposure and mini locking plate fixation is effective in reduction and fixation,and allows early functional rehabilitation.