侧接骨板治疗桡骨远端die-punch骨折可行性分析

Analysis of the feasibility of applying side-palm plates to treatment of die-punch fractures at distal radius

目的:分析应用掌侧接骨板方法治疗桡骨远端die-punch骨折的临床可行性。方法:选取我院2014年12月~2015年12月已接受掌侧接骨板治疗的远端die-punch骨折患者32例为对象。32例患者的die-punch骨折类型主要有三种,为纵向劈裂类型、掌侧类型、背侧类型。治疗所用的接骨板的类型为万向双柱锁定加压类型及2.4 mm T类型。患者手术后选择性进行一些功能恢复训练,如术后1个月内行手掌和指关节的活动,术后超1个月行腕关节活动训练。对32例患者进行随访,相关内容有X片、DASH评分、腕部是否出现畸形、并发症情况、握力、腕关节活动情况。探究采用不同die-punch骨折类类型和不同接骨板类型患者之间上述指标的差异。结果:成功随访了32例患者,经X片发现骨折愈合状况良好,且关节面也较为平整,未出现并发症和腕部畸形现象。不同die-punch骨折类型和不同接骨板类型患者DASH评分、握力、腕关节活动状况差异均无统计学意义(P>0.05)。结论:应用掌侧接骨板方法治疗桡骨远端die-punch骨折具有临床可行性。

Objective： To analyze the clinical feasibility of applying side-palm plates to treatment of die-punch fractures at the distal radius. Methods：Thirty-two cases of distal radius die-punch fractures treated with side-palm plates in our hospital were included from December of 2014 to 2015. The fracture types in the 32 patients were associated with vertical,volar and dorsal depression fractures. Side-palm plates used for fracture fixation included universal double-column locking compression type and 2.4 mm-T-type. After operation,all patients were instructed to have certain adaptive training for function recovery of the palm and finger joints as well as wrist,and followed from 12 to 42 months regarding the X-ray films,DASH scores,presence of deformed wrist,postoperative complications,gripping power and wrist movement. Then the results were compared between groups pertaining to different types of diepunch fractures treated with diverse plates. Results： X-ray films indicated well healed fractures with smooth joint surface in all patients. No complications or deformed wrist occurred. Different die-punch fractures treated with diverse plates had no significant difference in gripping power and wrist movement by DASH scoring（ P0.05）. Conclusion： Side-palm plates can be feasible to treatment of die-punch fractures at distal radius in clinic.