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2.4mm锁定加压接骨板治疗桡骨远端C型骨折的疗效分析 被引量:12

Type C fractures of distal radius treated with 2.4 mm locking compression plates
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摘要 目的探讨2.4mm锁定加压接骨板(LCP)治疗侥骨远端C型骨折的疗效。方法2008年1月至2010年12月采用2.4mm,CP治疗43例桡骨远端C型骨折患者,男3例,女40例;年龄50~78岁,平均60岁;骨折按AO分型:C1型13例,C2型18例,C3型12例。采用掌侧入路2.4mmLCP固定,术中若存在骨缺损,则予以植骨。记录并比较患者术前和术后不同时间点的掌倾角、尺偏角、桡骨茎突高度,术前38例患者行骨密度检查,根据其结果分为3组:骨量正常组(14例),骨蛩降低组(18例)和骨质疏松组(6组),对3组患昔术后的腕关节功能评分进行比较分析。结果43例患者术后获6~34个月(平均17个月)随访。1例患者关常面遗留台阶1mm;其余42例患者骨折均解剖复位,骨折愈合时间为6~10周,平均8周。术后12个月根据Gartland—Werlev评分系统评价腕关节功能:优8例,良32例,可3例,优良率为93.0%。本组患者术后即刻掌倾角、尺偏角、桡骨茎突高度与术前比较差异均有统计学息义(P〈0.05);术后12个川无明显复位丢失,与术后即刻比较差异均无统计学意义(P〉0.05)。骨量正常组、骨最降低组、骨质疏松组患者腕关竹GartIand—Wel-Icy评分平均分别为(3.9±1.6)、(3.7±1.3)、(5.7±0.5)分,骨质疏松组与其他两组比较差异均有统计学意义(P〈0.05)。结论2.4mm掌侧LCP治疗桡骨远端C型骨折可取得满意疗效,能够牢固固定并有效维持骨折复位。骨质疏松可能影响腕关节功能的恢复。 Objective To analyze the outcomes of type C distal radial fractures treated with 2.4 mm locking compression plates (LCP) . Methods From January 2008 to December 2010, 43 patients (43 sides) with type C distal radial fi'aeture were treated with 2.4 mm LCP. They were 40 women and 3 men, with an average age of 60 years (fi'om 53 to 78 years). According to the AO classification, 13 cases were of type C1. 18 cases of type C2 and 12 cases of type C3. All were fixated through the volar approach and bone defects were treated with bone grafts. Volar tilt, radial inclination, radial shortening, joint discrepancy were measured preoperation, immediately, 1, 3 and 12 months postoperation and compared between groups of normal bone density (14 eases), low bone density (18 eases) and osteoporosis (6 cases). Results The 43 patients were fl)llowed up Ior an average of 17 months (from 6 to 34 months). All fi'aetuws united well after an average of 8 weeks except for one case of nmlunion. By the Gartland-Werley sc, oring system, 8 cases were rated as excellent. 32 cases as good and 3 cases as fair, with an excellent to good rate of 93.0%. The volar tilt, radial inclination, radial shortening, joint discrepaney were improved significantly in all patients ( P 〈 0.05). No sig- nificant differences were observed in reduction loss between immediately and 12 months pnstoperation (P 〉 0. 05). The Garlland-Werley scores for the groups of normal bone density, low bone density and oslenpnrosis were respectively 3.9 ± 1. 6, 3.7 ± 1.3 and 5.7 ± 0. 5, with significant differences between osteoporotic cases and others ( P 〈 0.05). Conclusions Treatment of type C fraeture of distal radius with 2.4 mm LCP can lead to good resuhs radiologieally and functiomdly. Osteoporosis may influence the functional recovery of the wrist.
作者 赵亮 王宝军 李亚东 杨稳 刘振宇 高化 刘长贵 ZHAO Liang, IE4NG Bao-jun. LI Ya-dong, et al. Department of Orthopaedics, Beijing Friendship Hospital, Capital University of Medical Sciences, Beijing 100050, China
出处 《中华创伤骨科杂志》 CAS CSCD 北大核心 2012年第7期 557-560,共4页 Chinese Journal of Orthopaedic Trauma
关键词 桡骨骨折 骨板 骨折固定术 治疗结果 Radius fractures: Bone plates Fracture fixation, internal Treatment outcomes
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