掌侧锁定加压钢板治疗桡骨远端C型骨折

目的 探讨锁定加压钢板(LCP)内固定治疗桡骨远端AO分型C型骨折的初期疗效.方法 总结从2007年1月～2009年1月应用锁定加压钢板(LCP)内固定治疗桡骨远端C型闭合性骨折26例.手术采用掌侧入路,复位后于掌侧置入LCP钢板,在C型臂X线机透视下检查桡骨长度、桡骨关节面、掌倾角及尺偏角复位情况,满意后置入锁定螺钉,对于严重骨缺损者应予植骨.术后第1天开始被动活动腕关节,1周后主动活动,功能锻炼.结果 全部获得随访,平均11个月(8～21个月).X线显示骨折全部Ⅰ期愈合,平均愈合时间为8周,所有病例均无感染、骨不连、钢板松动、腕管综合征、正中神经炎等并发症.按改良的Mcbride腕关节功能评价标准:优18例,良6例,可2例,优良率为92.31％.结论 坚强内固定下早期进行腕关节功能锻炼是治疗粉碎及不稳定桡骨远端骨折的有效措施,使用锁定加压钢板(LCP)内固定治疗桡骨远端C型骨折具有复位满意、固定坚强、可早期进行功能锻炼、关节功能恢复优良等优点.

Treatment of type-C fracture of the distal radius with LCP internal fixation

【Objective】 To evaluate the therapeutic effect of treating AO type C fracture of the distal radius with open reduction LCP plate internal fixation.【Methods】 From Jan.2007 to Jan.2009,26 cases of AO type C fractures of the distal radius were treated with LCP plate internal fixation.All cases were fixated through volar approach,the length of radius,waist joint angle were recovered,screwed the plate,the exposure of dorsal soft tissues could be obtained by internal-rotate radius,allo-bone graft,and aoto-bone graft was necessary for the case with bone defect.Passive wrist motion,active finger motion and forearm rotation were encouraged immediately after surgery.Active wrist motion was suggested seven days postoperatively.【Results】 The 26 cases were followed up for 8 to 21 months,with an average time of 11 months.X-ray pictures showed that one-stage union was achieved in the patients,with a mean healing time of eight weeks.No such complications were found as infection,non-union,loosing of nails,carpal tunnel syndrome or medium neuritis.Their clinical outcomes were evaluated according to modified McBride grading system.Eighteen were rated as being excellent,six as good and two as fair,with their good-excellent rate as being 92.31%.【Conclusion】 Treatment of type C distal radius fracture with LCP plate internal fixation has many advantages,such satisfactory reduction,rigid fixation,and excellent function.