掌侧入路2.4mm万向锁定接骨板治疗老年桡骨远端AO-C型骨折的临床应用及疗效评价

Clinical application and curative effect evaluation of 2.4mm universal locking plate for the treatment of AO-C fractures in the distal radius of the elderly

目的探讨掌侧入路2.4 mm万向锁定接骨板治疗老年桡骨远端AO-C型骨折的临床疗效。方法选取2014年6月~2016年6月采用掌侧入路2.4 mm万向锁定接骨板治疗老年桡骨远端AO-C型骨折27例,男17例,女10例;左侧11例,右侧16例。按国际内固定研究学会(AO/OTA)分型:AO-C1型6例,AO-C2型9例,AOC3型12例。比较术后1周、术后8周及术后16周影像学指标,术后逐渐进行功能锻炼,术后6个月腕关节功能按Gartland-Werley功能评分标准进行疗效评估。结果所有患者获得6~12个月(平均7.6个月)随访。术后1周、术后8周及术后16周分别测量掌倾角[(12.17±3.57)°、(11.86±3.63)°、(11.77±4.37)°]、尺偏角[(20.25±5.17)°、(20.01±4.93)°、(19.89±5.17)°]、桡骨高度[(11.25±6.23)mm、(11.20±7.05)mm、(11.11±6.79)mm],术后1周、术后8周及术后16周分别较术前明显改善,差异有统计学意义(P<0.05)。术后6个月腕关节Gartland-Werley功能评分标准评定疗效:其中优11例,良15例,可1例,优良率为96.3%(26/27);并发症发生率为3.70%(1/27)。结论掌侧入路2.4mm万向锁定接骨板治疗老年桡骨远端AO-C型骨折可获得满意临床疗效,能有效防止骨折复位丢失和再移位,术中牢靠的固定、充分的植骨及术后早期的康复才是治疗的关键。

Objective To explore the clinical effect of the approach of2.4mm universal locking plate in the treatment of AO-C fractures in the distal radius ofthe elderly.Methods A total of27patients by using2.4mm universal locking plate for the treatment ofAO-C fractures in the distal radius ofthe elderly was selected from Jun2014to Jun2016.In these27cases,by comparison ofthe imaging parameters,and doing the postoperative functional exercise gradually,the wrist function was evaluated according to the Gartland-Werley function score at6months postoperatively.Results All patients were followed for6to12months after operation(average7.6months).1st week,8th week and16th week postoperatively,palmar angle were measured,ulnar deviation,radial height,there were significant improvements during the comparison of1st week,8th week,16th week after operation and before operation,the difference was statistically significant(P<0.05).The Gartland-Werley functional score of the wrist was evaluated at6months postoperatively.Among them,11cases were excellent,15cases were good,and the excellent and good rate was96.3%(26/27),the incidence of complications was3.70%(1/27).Conclusion Using the side ofthe approach2.4mm universal locking plate for the treatment of elderly patients with distal radius of AO-C fractures can be satisfied with clinical efficacy and effectively prevent the fracture reduction and re-shift,intraoperative fixation of the fixed,adequate bone graft and early rehabilitation is the key to treatment.