T型锁定加压接骨板与远端万向锁定加压接骨板治疗桡骨远端骨折的疗效分析

T-type comparison of locking compression plate versus variable angle locking compression plate in treatment of distal radial fractures

目的比较使用T型锁定加压接骨板和远端万向锁定加压接骨板在治疗桡骨远端骨折时的手术疗效。方法回顾性分析2011年12月-2015年11月于首都医科大学附属北京友谊医院骨科分别采用T型锁定加压接骨板与远端万向锁定加压接骨板治疗桡骨远端骨折的118例患者病例资料。T型锁定加压接骨板组60例；按AO／OTA分型，其中A3型3例，B2型5例，B3型7例，C1型10例，C2型20例，C3型15例。远端万向锁定加压双柱接骨板组58例；按AO／OTA分型，其中A3型1例，B2型2例，B3型4例，c1型15例，c2型18例，c3型18例。分析对比两组术后影像学参数、功能恢复情况。随访以门诊随访进行。掌倾角、尺偏角、桡骨高度、腕关节背伸、掌屈、尺偏、桡偏、旋前、旋后角度以及Gartland—Werley功能评分用均数＋标准差（x±s）表示，组间比较行t检验。结果所有患者术后均得到随访，T型锁定加压接骨板组平均随访时间26．5个月，远端万向锁定加压双柱接骨板组平均随访时间25．6个月。结果显示，在尺偏角、桡骨高度、桡偏角度以及Gartland-Werley功能评分方面两组间差异无统计学意义，在掌倾角、腕关节背伸、掌屈、尺偏、旋前、旋后角度方面两组间差异有统计学意义，远端万向锁定加压接骨板具有优势。结论采用两种内固定手术方式治疗桡骨远端骨折均获得满意的临床疗效，远端万向锁定加压接骨板更具有优势，临床手术应用可根据患者具体情况选择相应的内固定方式。

Objective To compare the clinical effects of the T- type volar locking compression plate and variable angle two-column locking compression plate in treatment of 118 cases with distal radial fractures. Methods Retrospectivly analyzed the clinical data of distal radius fracture cases from Dec. 2011 to Nov. 2015 in Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University who were respectively underwent T-type locking compression plate and variable angle two-column locking compression plate. The T-type locking compression plate group of 60 cases;according to AO/OTA classification, including 3 cases of type A3, type B2 5 cases, type B3 7 cases, type C1 10 cases, type C2 20 cases, type C3 in 15 cases. The variable angle two- column locking compression plate variable angle two-column locking compression plate group 58 cases; according to AO/OTA classification, including 1 cases of type A3, type B2 2 cases, type B3 4 cases, type C1 15 cases, type C2 18 cases, type C3 18 cases. Comparative analysis of two groups of postoperative radiographic parameters and functional recovery. Palm angle, ulnar deviation angle, radius height, wrist joint activity and G-W function score were measured by （x ± s）, and the comparison was performed t test. Results All patients were followed up, mean follow-up time of T-type locking compression plate group was 26.5 months, the mean follow-up time of variable angle two-column locking compression plate group was 25. 6 months. The results showed that there were no significant differences between the two goups in ulnar deviation angle, radius height, radial deviation angle and Gartland-Werley function score. There was significant difference between the two groups in the angle of palm angle, wrist dorsal extension, palmar flexion, ulnar deviation, Wrist rotation, and variable angle two-column locking compression plate had advantages. Conclusion Two kinds of treatment of distal radius fractures were satisfactory clinical efficacy, and variable angle two-column locking compression plate had more advantages, doctors can choose corresponding fixation methods according to the specific situation of patients.