T形钢板内固定结合外固定架治疗不稳定性桡骨远端骨折

目的探讨T形钢板内固定结合外固定架治疗不稳定性桡骨远端骨折的临床疗效。方法9例桡骨远端骨折,按AO分型:B型2例,C型7例。均采用切开复位T形钢板内固定结合外固定架手术治疗。术后随访桡骨长度、掌倾角、尺偏角、腕关节活动范围。结果9例分别随访6～12个月,平均8个月。所有患者均达到解剖复位,骨折愈合良好。按照Gartland与Werley评分标准,优8例,良1例。术后腕关节活动范围背伸平均为45°,掌屈为54°,尺偏为88°,桡偏为27°;前臂旋前为88°,旋后为82°。所有病例均无内固定松动、骨折移位、针道感染、肌腱损伤等并发症。结论切开复位T形钢板内固定可良好维持骨折处对位对线,恢复关节面的平整;结合外固定架可以防止术后骨折再塌陷,维持桡腕关节间隙正常位置,保护早期功能锻炼,是治疗桡骨远端骨折的有效方法。

Treatment of distal radius fracture by T-shaped plate internal fixation combined with external fixation

Objective To summarize our experience in treatment of distal radius fracture by T-shaped plate internal fixation combined with external fixation.Methods Nine cases of unstable fracture of distal radius were included.There were two cases of type B and seven cases of type C according to AO classification.They were all treated by T-shaped plate fixation combined with external fixation.Autogeneic bone grafting was applied in eight patients.All the nine cases were followed up to evaluate their wrist joint range of active motion and radiographic parameters including palmar tilt,dorsal tilt,radial inclination,radial length and ulnar variance.Results All the patients were followed up for 6 to 1 2 months postoperatively(mean eight months).Anatomical reduction was achieved in all the cases.Delayed union or non-union was not observed.According to the rating scale of Gartland and Werley,eight cases got excellent results and one case good results.By the time of last follow-up,no such complications as pin hole infection,loosening of internal fixation,loss of reduction,tendon rupture or irritation occurred.Conclusion T-shaped plate fixation combined with exter nal fixation is reliable and effective in treatment of unstable fracture of distal radius.