掌侧柱锁定接骨板治疗桡骨远端C型骨折的疗效分析

Volar locking plate for treating type C fractures of distal radius

背景：掌侧柱锁定接骨板已经广泛应用于桡骨远端骨折，尤其在桡骨远端C型骨折。目的：探讨掌侧柱锁定接骨板治疗桡骨远端C型骨折的疗效。 方法：回顾分析2011年5月至2013年6月采用掌侧柱锁定接骨板治疗并获完整随访的38例桡骨远端C型骨折患者的临床资料，男12例，女26例；年龄40-77岁，平均59岁。根据AO骨折分型：C1型9例，C2型18例，C3型11例。全部患者均采用掌侧入路，掌侧柱锁定接骨板固定，术后定期随访，观察骨折愈合情况及腕关节功能结果。 结果：38例患者术后获得6-31个月（平均15个月）随访；骨折愈合时间4-10周，平均8周。2例背侧骨片轻度移位，其余患者骨折均获解剖复位。腕关节VAS评分：完全无痛32例，中度疼痛1例，轻度疼痛5例。按改良的Gartland-Wer-ley评分：优23例，良12例，可3例。 结论：掌侧柱锁定接骨板符合桡骨远端“分水岭”的解剖结构，能够牢固固定桡骨远端C型骨折并维持骨折复位。

Background：Volar locking plate has been widely applied in distal radius fractures, especially in type C distal radius fractures. Objective：To evaluate clinical outcomes of type C radial fractures fixed by volar locking plate. Methods：From May 2011 to June 2013, 38 patients with type C distal radial fracture were treated with volar locking plate. They were 12 men and 26 women with an average age of 59 years （range, 40-77 years）. According to the AO classification, there were 9 cases of type C1, 18 of type C2 and 11 of type C3. All fractures were fixed through volar approach. The bone healing and wrist joint function were observed during follow-up. Results：The mean follow up period was 15 months （range, 6-31 months）. The fractures were healed 8 weeks （range, 4-10 weeks） after surgery. Wrist VAS score：There were 32 cases without pain, one with moderate pain, 5 with mild pain. Treat-ment outcome was excellent in 23 cases, good in 12 and fair in 3 according to the Gartland-Werley scoring system. Conclusions：Volar locking plate is fit for the line with the watershed of distal radius anatomy. The type C distal radius frac-ture can be firmly fixed by the plate and satisfactory curative effect can be achieved.