掌侧入路切开复位锁定钢板治疗高龄桡骨远端不稳定骨折

Volar admission in the treatment of unstable fracture of distal radius in elder patients with open reduction and locking plate

目的 探讨掌侧入路切开复位锁定钢板治疗高龄桡骨远端不稳定骨折的临床疗效。方法 高龄桡骨远端不稳定骨折患者28例,男3例,女25例,年龄75-85岁,平均79岁。按AO/ASIF分型,A3型20例,B3型4例,C1型3例,C2型1例,伴有高血压或糖尿病22例,伴有慢性支气管炎12例,慢性房颤4例。所有病例伤前生活基本自理,均为闭合性骨折。术前积极控制血糖、血压及其他内科疾病。手术方法均采用掌侧入路切开复位锁定钢板固定,手术平均时间60分钟左右,术后早期功能锻炼。结果 所有患者均获随访,随访时间4-12月,平均7个月。按Dienst标准评定疗效：优14例,良10例,可3例,差1例,优良率85%。结论 对于高龄桡骨远端不稳定性骨折患者,术前积极准备,通过掌侧入路切开复位锁定钢板固定,疗效满意。

Objective To explore the clinical effect of Volar admission in the treatment of unstable fracture of distal radius in elder patients with open reduction and locking plate. Methods 28 cases of unstable fracture of distal radius in elder patients, male 3, female 25, age 75 to 85 years old, average 79 years old. According to AO/ASIF classification, 20 cases were A3 type, 4 cases were B3 type, 3 cases were C1 type, 1 case was C2 type; 22 cases were accompanied with hypertension or diabetes, 12 cases with chronic bronchitis, 4 cases with chronic atrial fibrillation. All cases can finish the basic care of life before injury and are closed fractures. Control blood sugar and blood pressure and other diseases with department of internal medicine. The surgical methods were operated with the open reduction and locking plate fixation, the average time was 60 minutes, and the early functional exercise after operation. Results All the patients were followed up for 4 months to 12 months. The average was 7 months. According to Dienst standard, the efficacy was excellent in 14 cases, good in 10 cases, fair in 3 cases, poor in 1 case, the fine rate was 85%. Conclusion For the elderly patients with unstable fractures of the distal radius, with the preoperative preparation, the treatme with open reduction and locking plate is an effective treatment.