背侧钢板辅助固定桡骨远端月骨窝背侧骨折块

Dorsal plate assisted fixation of dorsal lunate fossa fracture of distal radius

目的:探讨背侧钢板辅助固定桡骨远端月骨窝背侧骨折块的临床疗效。方法:自2019年1月至2022年1月,采用背侧钢板辅助固定30例桡骨远端月骨窝背侧骨折块患者,其中男13例,女17例;年龄42~68(48.7±5.6)岁;骨折参照Doi分型:3块型24例,4块型6例。术中透视背侧钢板固定前后桡骨远端掌倾角度数,术后观察骨折愈合和腕关节功能恢复情况,术后12个月采用Gartland和Werley评分系统进行功能评价。结果:所有患者获得随访,时间12~13(11.3±0.9)个月。骨折全部愈合,时间4~5(4.7±0.8)个月。背侧钢板固定前、后桡骨远端掌倾角中位数(P25,P75)分别为5.30°(4.85°,6.03°)、12.45°(11.98°,13.43°),差异有统计学意义(P<0.01)。术后12个月Gartland和Werley评分(1.1±0.4)分,优27例,良3例。结论:背侧钢板辅助固定有利于月骨窝背侧骨折块的复位和掌倾角的恢复。

Objective To explore clinical efficacy of dorsal plate assisted fixation of dorsal lunate fossa fracture block of distal radius.Methods From January 2019 to January 2022,30 patients were treated with dorsal plate assisted fixation of dorsal lunate fossa fracture of distal radius,including 13 males and 17 females,aged from 42 to 68 years old with an average of(48.7±5.6)years old;According to Doi fracture classification,24 patients were type 3 blocks and 6 patients were type 4 blocks.The degree of palmar angle of anterior and posterior distal radius was fixed by dorsal steel plate during operation.Fracture healing and functional recovery of wrist were observed after operation.Functional evaluation was performed by Gartland and Werley scoring system at 12 months after operation.Results All patients were followed up from 12 to 13 months with an average of(11.3±0.9)months.All fractures healed for 4 to 5 months with an average of(4.7±0.8)months.Median palpal inclination of anterior and posterior distal radius fixed by dorsal plate was 5.30°(4.85°,6.03°),12.45°(11.98°,13.43°)respectively,and had statistical difference(P<0.01).Gartland and Werley scores was(1.1±0.4)at 12 months afteropertaion,and 27 patients got excellent result and 3 good.Conclusion Dorsal plate assisted fixation of dorsal lunate fossa fractures is beneficial to reduction and stabilization of displaced dorsal fractures and restoration of palmar inclination.