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桡骨远端粉碎性骨折掌背侧不同手术入路疗效比较 被引量:28

Comparison between volar and dorsal plate positions in treatment of comminuted fractures of distal radius
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摘要 目的探讨掌背侧不同手术入路对治疗桡骨远端粉碎性骨折的疗效影响.方法对我院自2000年11月~2003年9月收治的85例桡骨远端粉碎性骨折患者(Fernandez Ⅴ型),随机分为A、B两组.分别经腕掌侧(A组)及背侧(B组)入路切开行钢板内固定术.从手术时间、骨折愈合时间、术后早期并发症、术后远期并发症、术后第8周、第24周腕关节功能恢复等方面比较两组差别.结果所有患者术后随访6~36个月,平均13.7个月.参照Gartland和Werley腕关节功能评分,A、B两组术后第24周腕关节功能优良率分别为87.2%和86.8%;放射学评价参照Lidstrom评分,A、B两组桡骨关节面恢复优良率分别为93.2%和91.8%.A、B两组在手术时间、骨折愈合时间、术后早期并发症、术后第24周腕关节功能恢复等方面差异无显著性意义(P>0.05);A、B两组在术后远期并发症、术后第8周腕关节功能恢复方面差异有显著性意义(P<0.01).结论掌背侧不同手术入路对治疗桡骨远端粉碎性骨折的疗效有影响.掌侧入路钢板内固定术后早期,腕关节旋前功能受影响;背侧入路钢板内固定术后远期并发症较多,骨折愈合后宜尽早拆除内固定钢板. Objective To compare the differences between v olar and dorsal plate positions in th e treatment of comminuted fractures of distal ra dius.Methods From November 2000to September 2003,85cases of com-minuted fracture of distal radius(FernandezⅤtype)were randomized into 2groups and were fixed either at the volar plate position(Group A)or at the dorsal plate position(Group B ).All the cases were followed up for an average of13.7months(6to 36months).The clinical results of the 2groups were documented and compared in the f ollowed aspects:operation time,healing time,early complications,latest com plications,the wrist functions at t he postoper-ative 8th and 24th weeks.Results According to Gartland and Werley score,the excellent and good rate of wrist function was 89.4%in Group A and 86.8%in Group B at the post-operative 24t h week.According to Lidstrom radiological score,the excellent a nd good rate of radial articular surface restored was 93.2%in Group A and 91.8%in Group B.The differences between t he 2groups in healing time,operatio n time,early complications and the wrist function at post-operative 24th week were of no statistical significance(P>0.05);while those in the latest com-plications and the wrist function at post-operative 8th week were of statistical significance(P<0.01).Conclusion The differences between the volar an d dorsal plate positions have an effe ct on treatment of comminuted fractu res of distal radius.The volar plate posit ion may influence the pronation of th e forearm,while the dorsal plate position may cause increased latest complicatio ns so that the plate should be removed soon after the union occurs.[
作者 张经纬 曾炳芳 冯建翔 吴志军 杨立峰 徐荣明 ZHANG Jing-wei 1 ,ZENG Bing-fang 2 ,FENG Jian-xiang 1 ,WU Zhi-jun 1 ,YANG Li-feng 1 ,XU Rong-ming 11 Department of Orthopaedics,Ningbo Sixth Hospital,Ningbo,Zhejiang 315040,China 2 Department of Orthopaedics,The Six th Peoples Hospital,Shanghai Jiaotong University,Shanghai 200233,C hina
出处 《中华创伤骨科杂志》 CAS CSCD 2005年第6期 501-504,共4页 Chinese Journal of Orthopaedic Trauma
关键词 桡骨 骨折 手术入路 比较 Radius Fracture Surgical approach Comparison
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参考文献10

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