A comparative study of outcome between the Neuflex and Swanson metacarpophalangeal joint replacements

This prospective double blind trial compares the clinical findings of Swanson and Neuflex metacarpophalangeal joint replacements in patients with rheumatoid arthritis, up to 2 years follow-up. There were 37 joints (10 patients) in the Swanson group and 40 joints (12 patients) in the Neuflex group. Assessments of range of movement, grip strength and hand function were undertaken in a double blind fashion, pre-operatively and up to 2 years following implantation. The mean and standard deviation of the data were calculated. A two-tailed student's t-test was used when comparing groups of data. An X-ray analysis was also undertaken to identify any implant failure. There was no significant difference between the two groups with respect to flexion and extension before surgery. At follow-up there was also no significant difference in the extensor lag, with mean extension lags of 19 degrees and 16 degrees for the Swanson and Neuflex implants, respectively. However, there was a significant difference in flexion, with mean active flexion values of 59 degrees and 72 degrees for the Swanson and Neuflex implants, respectively. There were no differences between the two groups in respect to arc of metacarpophalangeal joint motion, ulnar deviation, grip strength or the SODA function test at follow-up. At this early stage there was no evidence of any case of implant failure. In conclusion, patients who underwent Neuflex metacarpophalangeal joint replacements obtained greater flexion than those who underwent a Swanson replacement.     

Survival and complications are similar after Swanson and Sutter implant replacement of metacarpophalangeal joints in patients with rheumatoid arthritis

We compared the survival, fracture, and deformation rates of Swanson and Sutter implants in a prospective series of 53 patients with rheumatoid arthritis (RA). Fifty-eight hands were operated on with 215 silastic implants. The Swanson group comprised 25 hands and 89 implants, and the Sutter group 33 and 126, respectively. Follow up was 58 (37–80) months. During a period of 48 months the survival of Swanson and Sutter prostheses did not differ significantly: 92% (95% CI 84% to 96%) and 97% (95% CI 92% to 99%), respectively. The fracture rate was high in both groups: 26 (34%) in the Swanson and 25 (26%) in the Sutter group. There was no significant difference between the groups in definite fracture rates of implants. The Sutter prosthesis appears to be at least as durable an implant in rheumatoid patients’ metacarpophalangeal arthroplasty as the Swanson.     

Computer model analysis of the Swanson and Sutter metacarpophalangeal joint implants

A representative model which mimics the behaviour of Silastic finger metacarpophalangeal joint implants was constructed using a finite element software package. The modelled implants were moved through a range of flexion, lateral deviation and a combination of both. Pistoning of both implants stems occurred within the modelled medullary cavities. For equivalent flexion angles, the Sutter implant produced a higher stress field than the Swanson implant, and the field was positioned at the central hinge mechanism. In both implants, lateral deviation increased the internal stress concentrations more than when pure flexion was applied. Overall the Swanson style of implant had lower stress magnitudes than the Sutter implant, and it is predicted that the Sutter implant will be more likely to fail than the Swanson. The failure mode for the Sutter implant would be at the central hinge region. The Swanson implant is likely to fail at the central hinge-stem interface regions.     

Insufficient Flexion of the Metacarpophalangeal Joint of the Little Finger Following Swanson Silicone Arthroplasty for Rheumatoid Arthritis

Twenty-one patients with rheumatoid arthritis who underwent Swanson metacarpophalangeal (MP) arthroplasty from 1994 to 1999 were assessed for active flexion of individual MP joints an average of 59 months (range 27–114 months) postoperative. Published articles of Swanson MP arthroplasty were reviewed. Experienced hand surgeons were surveyed regarding outcomes of metacarpophalangeal arthroplasty. The MP joint of the little finger displayed significantly less flexion than that of the middle and index finger. Seven of eight published studies which present active MP flexion by individual digit demonstrated less flexion in the little finger compared to the index, middle, and ring finger. Half of surgeons surveyed reported that MP range of motion is shifted toward a more extended position, that MP flexion is limited in the ulnar digits, and that an implant that encourages MP flexion would be helpful. Our experience with this cohort, a review of published literature, and a survey of international experts suggest that Swanson arthroplasty frequently results in a range of flexion of the MP joint of the little finger that may be insufficient for its principal functions.     

Survival and complications are similar after Swanson and Sutter implant replacement of metacarpophalangeal joints in patients with rheumatoid arthritis.

We compared the survival, fracture, and deformation rates of Swanson and Sutter implants in a prospective series of 53 patients with rheumatoid arthritis (RA). Fifty-eight hands were operated on with 215 silastic implants. The Swanson group comprised 25 hands and 89 implants, and the Sutter group 33 and 126, respectively. Follow up was 58 (37-80) months. During a period of 48 months the survival of Swanson and Sutter prostheses did not differ significantly: 92% (95% CI 84% to 96%) and 97% (95% CI 92% to 99%), respectively. The fracture rate was high in both groups: 26 (34%) in the Swanson and 25 (26%) in the Sutter group. There was no significant difference between the groups in definite fracture rates of implants. The Sutter prosthesis appears to be at least as durable an implant in rheumatoid patients' metacarpophalangeal arthroplasty as the Swanson.     

Extensor indicis proprius transfer for the abducted small finger

PURPOSE: Persistent abduction of the small finger has usually been treated by transfer of the extensor digiti minimi muscle. However, anatomic variations of the extensor system may limit the potential for a successful extensor digiti minimi transfer. Therefore, we evaluated the outcomes of an alternative reconstruction method for the abducted small finger using an extensor indicis proprius (EIP) transfer. METHODS: We performed 8 EIP transfers in 8 patients with persistent, flexible abduction posturing of the small finger. The primary etiology of the deformity was incomplete motor reinnervation after surgeries for ulnar neuropathy in 6 patients, rupture of the third palmar interosseous musculotendinous unit in 1 patient, and intrinsic muscle fibrosis in 1 patient. The EIP was elongated by splitting the tendinous portion and was transferred to the distal and radial part of the extensor hood. Surgical outcomes were assessed by comparing preoperative and postoperative active adduction and abduction motion of the 2 ulnar digits. RESULTS: At the mean follow-up of 23 months, the average adduction angle improved from 19 degrees to 1 degrees postoperatively. In terms of active finger motion, 6 patients showed excellent results, 1 good, and 1 fair, without loss of flexion and extension. No patient had an extension lag or complained of functional deficits of the donor index finger. There was not adverse change to digital function or range of motion for the middle and ring fingers that are crossed by the EIP. CONCLUSIONS: Extensor indicis proprius transfer can be a reliable option for correction of abduction deformity of the small finger, maintaining active abduction and full flexion and extension. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.     

Unreconstructible radial head fracture: resection, implant of Swanson or prosthesis? Retrospective comparative study

Treatment of unreconstructible comminuted fractures of the radial head remains a therapeutic challenge. Thirty two patients sustained unreconstructible radial head fracture between 1969 and 1999 and have been treated by resection (16 patients), by Swanson implant (8 patients), or by Judet prosthesis (8 patients). The three groups of patients were reviewed clinically and radiologically by two surgeons not involved in their treatment. Functional outcomes of the elbow (Morrey scoring-SOO scoring system, instability, cubitus valgus) and involvement of the wrist (pain, grasp, RUD instability) were evaluated with a mean follow up of 15 years (6-27.7). Elbow or wrist arthritis, ulnar variance, and evolution of Swanson implants were evaluated on standard radiographs. The Judet prosthesis group was evaluated with DASH scoring. Half of the patients were male and 1/3 had a work-related injury. Regarding the following criteria, there was no significant difference between the resection and the Swanson group: Morrey scoring 77/100, SOO scoring 7.4/11, mean flexion was 130 degrees, mean deficient extension was 18 degrees, mean pronation 60 degrees, mean supination 67 degrees, grasp reached 90% of the controlateral side. Arthritis was noted with the same frequency at the elbow (87%), and wrist levels (66%) in each group. Ninety four percent (94%) of patients in the resection group and 89% in the Swanson group were satisfied. Excellent and good results were reported more frequently in the Swanson group (37% resection group, 51% Swanson group). In the resection group the following complications were significantly more frequent: ulnar nerve irritation (2 x), ulnar head dislocation (2 x), ulnar head instability (3 x), para articular ossification (5 x), ulnar variance positive in all cases (mean value 3.20 mm). In the Swanson group only two implants were found to be destroyed at follow-up. In the prosthesis group function and satisfaction were higher than the two other groups but with a shorter follow up. Excellent and good results were reported in 62.5% cases with a DASH scoring between 0 and 16.7. Comminuted fractures of the radial head treated by resection or Swanson implant are both followed by fair results (same functional scoring). Only the level of complications differs between groups: at elbow level for Swanson group, at wrist level for the resection group. Patients in the Swanson group were most frequently satisfied. Metal radial head implant is an attractive solution yielding good functional outcomes in recent reported limited series and in our personal experience, but with a very short follow-up.     

Avanta versus Swanson silicone implants in the MCP joint--a prospective, randomized comparison of 30 patients followed for 2 years

The results of Swanson and Avanta metacarpophalangeal joint arthroplasties in rheumatoid patients were compared in a prospective, randomized study of 30 patients (120 implants). At 2-year follow-up, grip strength was measured, hand function was assessed with the Sollerman test and the subjective outcome was determined with visual analogue scores. With both implants ulnar deviation and flexion deformities decreased, and there was no difference between the groups. The increase in range of motion was 7 degrees greater with Avanta implants than with Swanson implants. Grip strength and hand function were unaltered but the visual analogue scales showed decreased pain levels and subjective improvements in hand function, grip strength and cosmesis. Twenty-four of 30 patients were satisfied. Fracture of the silicone spacer occurred with 12 Avanta (20%) and eight Swanson implants (13%), with a higher fracture frequency in men.     

Measurement of gliding resistance of the extensor pollicis longus and extensor digitorum communis II tendons within the extensor retinaculum

PURPOSE: The etiology of spontaneous extensor pollicis longus (EPL) tendon rupture is still largely unknown. It is possible that friction within the sheath may play a role. The purposes of this study were to compare gliding resistance of the EPL tendon with that of the extensor digitorum communis tendon of the index finger (EDC II) and to find the wrist position that gives the EPL tendon the lowest gliding resistance. METHODS: Fifteen fresh-frozen cadavers were used. Gliding resistance was measured directly in 7 different wrist positions. RESULTS: The mean gliding resistance of the EPL tendon was 0.16 +/- 0.08 N and that of the EDC II tendon was 0.11 +/- 0.06 N. This difference was significant. There was also a significant effect on gliding resistance due to wrist position. For the EPL tendon, the gliding resistance was significantly greater in 60 degrees wrist flexion compared with all other wrist positions tested. Additionally the gliding resistance of the EPL in 30 degrees flexion, 60 degrees extension, and 15 degrees radial deviation was significantly higher than wrist positions of 30 degrees extension, neutral, and 30 degrees ulnar deviation. CONCLUSIONS: Positioning the wrist close to neutral flexion/extension and in some ulnar deviation minimizes the friction within the EPL sheath. Such positions may be advantageous for splinting patients at risk for EPL rupture.     

Fusion of the wrist in rheumatoid arthritis: a clinical and functional evaluation of two surgical techniques

We retrospectively compared wrist arthrodesis using the Mannerfelt technique in 19 or an AO-plate in 23 patients with long-standing rheumatoid arthritis. The mean follow-up was for 76 months. Compared with the Mannerfelt fusion group, patients in the AO-plate group reported greater satisfaction with their wrist function (74% vs 37%, p = 0.015). Complications were reported in six wrists in the AO-plate group and two wrists in the Mannerfelt fusion group (p = 0.258). At final follow-up, 95% of patients (41) reported either no pain or only mild pain. There was improvement in flexion of the finger joints in both groups but no significant improvement in the extension lag in either group. Both methods relieve pain and improve function. Overall, the activities of daily living scores and the patients' subjective assessment of outcome tended to be higher in the AO-plate group than in the Mannerfelt fusion group, although the difference was not statistically significant. Similarly, although more postoperative complications occurred in the AO-plate group, the difference between the two groups was not statistically significant.     

不同内固定在舟大小多角骨融合术中稳定性的比较研究

目的 比较舟骨和大、小多角骨(scaphoid-trapezium-trapezoid,STT)融合器与克氏针在STT融合术中内固定强度的差异.方法 12侧新鲜冷冻尸体前臂标本,随机分为融合器组(使用STT融合器)和克氏针组(使用克氏针)2组,模拟进行STT融合术,术后以夹具固定于腕动力测试仪上模拟腕关节主要活动.活动前后均拍摄腕关节标准正侧位X线片,测量桡舟角、桡舟间距、舟骨长度及STT融合体稳定角.结果 融合器组:当腕关节运动范围增加到屈曲45°、背伸40°、尺偏30°、桡偏15°时,客观指标与初始状态相比较变化差异均无统计学意义(P＞0.05).克氏针组:当腕关节运动范围增加到屈曲35°、背伸30°、桡偏10°时,客观指标与初始状态相比较变化差异均有统计学意义(P＜0.05).尺偏30°运动后融合体稳定角与初始状态相比较差异有统计学意义(P＜0.05).结论 STT融合器在舟骨和大、小多角骨融合术中内固定强度大于传统内固定物中的克氏针.     

Scaphoid kinematic behavior after division of the transverse carpal ligament

PURPOSE: The effect that carpal tunnel release (CTR) has on scaphoid motion has not been reported. Accordingly the purpose of this study was to determine the flexion/extension behavior of the scaphoid during global wrist radial/ulnar deviation before and after division of the transverse carpal ligament (TCL). METHOD: In this study we examined the in vitro kinematics of the scaphoid during wrist deviation in 6 cadaver forearms both before and after the division of the TCL using a computerized camera monitoring system. The specimens were evaluated in 13 different positions, from 20 degrees of radial deviation to 40 degrees of ulnar deviation at increments of 5 degrees. RESULTS: The data indicate that the difference in scaphoid position after TCL division is statistically significant when the wrist is in ulnar deviation of 15 degrees or greater. In addition a significant difference in scaphoid extension between pre- and post-TCL division conditions was found at 5 degrees of radial deviation as well as at 5 degrees or more of ulnar deviation and increased with increasing ulnar deviation. CONCLUSIONS: Scaphoid kinematics are altered considerably in radial-ulnar deviation after division of the TCL. This alteration may have long-term consequences and contribute to commonly seen post-CTR symptoms.     

Median nerve deformation and displacement in the carpal tunnel during index finger and thumb motion

The purpose of this study was to investigate the deformation and displacement of the normal median nerve in the carpal tunnel during index finger and thumb motion, using ultrasound. Thirty wrists from 15 asymptomatic volunteers were evaluated. Cross‐sectional images during motion from full extension to flexion of the index finger and thumb were recorded. On the initial and final frames, the median nerve, flexor pollicis longus (FPL), and index finger flexor digitorum superficialis (FDS) tendons were outlined. Coordinate data were recorded and median nerve cross‐sectional area, perimeter, aspect ratio of the minimal‐enclosing rectangle, and circularity in extension and flexion positions were calculated. During index finger flexion, the tendon moves volarly while the nerve moves radially. With thumb flexion, the tendon moves volarly, but the median nerve moves toward the ulnar side. In both motions, the area and perimeter of the median nerve in flexion were smaller than in extension. Thus, during index finger or thumb flexion, the median nerve in a healthy human subject shifts away from the index finger FDS and FPL tendons while being compressed between the tendons and the flexor retinaculum in the carpal tunnel. We are planning to compare these data with measurements in patients with carpal tunnel syndrome (CTS) and believe that these parameters may be useful tools for the assessment of CTS and carpal tunnel mechanics with ultrasound in the future. Published by Wiley Periodicals, Inc. J Orthop Res 28:1387–1390, 2010     

Influence of lunate type on scaphoid kinematics

PURPOSE: To assess the influence of lunate type on scaphoid kinematics. METHODS: One hundred normal wrists had fluoroscopic assessment of the wrist in maximal radial, neutral, and ulnar deviation. The shortest distance in a neutral position between the capitate and triquetrum, C-T distance, determined lunate type. A type I lunate had a C-T distance of < or =2 mm, a type II lunate > or =4 mm, and an intermediate group lay between these values. Scaphoid flexion and translation in radial and ulna deviation was measured. RESULTS: There were 18 subjects with a type I lunate, 19 with an intermediate lunate, and 63 with a type II lunate. There was no statistically significant difference between lunate type, subject age, or hand dominance. There was a statistically significant higher proportion of women with a type I lunate. Subjects with a type II lunate had a statistically greater amount of flexion during radioulnar deviation as determined by CR index (0.79 vs 0.91) and scaphoid flexion index (0.21 vs 0.09). Subjects with a type II lunate had statistically less translation during radioulnar deviation as determined by translation ratio (0.22 vs 0.31) and scaphoid inclination index (0.18 vs 0.23). The average scaphoid kinematic index in subjects with a type II lunate was 1.24, intermediate 0.86, and type I 0.42. A scaphoid kinematic index of greater than 1 indicates the scaphoid has more flexion during radioulnar deviation than translation. CONCLUSIONS: Wrists with a type I lunate show statistically greater scaphoid translation with radial deviation. Wrists with a type II lunate show statistically greater scaphoid flexion with radial deviation. Intermediate lunates have intermediate scaphoid mechanics. This allows the surgeon to determine the likely wrist scaphoid mechanics based on the lunate type determined from a single posterior-anterior x-ray.     

晚期月骨无菌性坏死舟骨环形征的解剖学及生物力学研究

目的明确稳定舟骨近极的韧带及断裂后桡腕关节面应力的改变,阐明舟骨环形征的临床意义. 方法实验分为两部分,分别通过5侧上肢标本的解剖学观察,确定稳定舟骨近极的韧带;通过桡侧、尺侧屈腕肌腱及桡侧、尺侧伸腕肌腱,垂直加载12 kg负荷5分钟,应用压敏薄膜及FPD-305E、FPD-306E系统,分别测量腕关节中立、掌屈、背伸、尺偏及桡偏时,正常及韧带断裂后舟骨窝、月骨窝应力的变化. 结果解剖学观察发现,稳定舟骨近极的韧带为:桡舟头韧带、长桡月韧带及舟月骨间韧带,其中长桡月韧带和舟月骨间韧带起到限制舟骨近极向背侧移位的作用.生物力学研究结果表明,在稳定舟骨近极的韧带断裂后,背伸位时,舟骨窝桡侧亚区应力(0.90±0.43)与正常(0.85±0.15)无差异,但掌侧(0.59±0.20)、尺侧(0.52±0.05)及背侧亚区(0.58±0.23)应力较正常(相对应力为0.77±0.13、0.75±0.08、0.68±0.09)减小;中立、掌屈、桡偏及尺偏位时,舟骨窝内各亚区应力与正常相比增大或无差异;而月骨窝在中立位时,各亚区的应力增大;掌屈、背伸、桡偏及尺偏位时,各亚区的应力减小或无差异. 结论在月骨无菌性坏死ⅢB期,舟骨窝承受的负荷增加,在治疗方法的选择上,应注意矫正舟骨的旋转半脱位,防止后期出现桡舟关节创伤性关节炎.     

π型锁定加压接骨板治疗Barton骨折

目的 探讨切开复位π型锁定加压接骨板(π-LCP)内固定治疗Barton骨折的效果. 方法 2006年1月至2007年1月,对21例Barton骨折患者采用背侧入路切开复位π-LCP内固定进行治疗.其中14例植骨,6例辅以石膏托保护. 结果术后所有患者获得6～18个月(平均10个月)随访,所有骨折均愈合.患者手术前、后在掌倾角、尺偏角、桡骨远端相对长度方而差异有统计学意义(P<0.05).随访时患侧腕关节在背伸、掌屈、桡偏等方面与健侧比较差异无统计学意义(P>0.05);尺偏角小于健侧,差异有统计学意义(t=2.548,P<0.05).用改良的Gartland和werkey评分系统评估腕关节功能:优15例,良4例,中2例,优良率为90.5%. 结论背侧入路切开复位π-LCP内固定是治疗Barton骨折的有效方法.     

Brachialis muscle transfer to reconstruct finger flexion or wrist extension in brachial plexus palsy

PURPOSE: Tendon transfers are a routine procedure used to improve hand function in brachial plexus injuries; however, muscles from forearm donors are not always available for transfer. In this situation a distant muscle may be used. This study describes transfer of the brachialis muscle to the forearm muscles to reconstruct finger flexion or wrist extension in patients with brachial plexus injuries. METHODS: In 6 patients the brachialis muscle was transferred to the flexor digitorum profundus and the flexor pollicis longus to restore finger and thumb flexion with the goal of reconstructing a key pinch and hook grasp. In 3 patients the brachialis muscle was transferred to the extensor carpi radialis brevis to restore wrist extension. The patients were evaluated at regular intervals and had final assessments between 10 and 12 months after surgery. RESULTS: Brachialis transfer to the flexor digitorum profundus and the flexor pollicis longus resulted in active motion with full range of digital flexion in the 2 patients who had partial flexion before surgery, and for the 4 patients who had no finger flexion before surgery it resulted in a pulp-to-palm distance for the middle finger of 1 cm in 3 patients and of 2 cm in 1 patient. A lateral key pinch and hook grasp reconstruction was achieved in all patients. Grasping and lateral pinch strengths averaged 110 and 94 mm Hg, respectively. When the brachialis was transferred to the wrist extensors the patients recovered 20 degrees of active wrist extension against resistance. CONCLUSIONS: Brachialis muscle transfer to the forearm muscle constitutes a valid strategy in the reconstruction of finger and thumb flexion and wrist extension after brachial plexus injury when forearm donor muscles are not available. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic, Level IV.     

Effects of reconstructed radial collateral ligament on index finger mechanics

Twenty fresh frozen hand specimens from cadavers were studied. Physiologic levels of extrinsic muscle loads were applied to the extrinsic flexor tendons of the index finger to simulate tip pinch of the finger on a fixed plate. The acute effects of transection of the radial collateral ligament and accessory radial collateral ligament (radial collateral ligament complex) with and without transection of the dorsal capsule and volar plate on the position of the proximal phalanx with respect to the metacarpal bone of the index finger were investigated. The acute effects of reconstruction of the radial collateral ligament, for each of two different surgical techniques, on the position of the proximal phalanx also were investigated. The spatial positions of the metacarpal bone and proximal phalanx were measured with a six-degree-of-freedom digitizing system for flexion angles from 0 degrees to 90 degrees in increments of 15 degrees. Transection of the radial collateral ligament complex resulted in significant increases in ulnar deviation (adduction) of the proximal phalanx and in volar translation. Additional transection of the dorsal capsule and volar plate caused significant increases in ulnar deviation, pronation, volar translation, and ulnar shift. The first surgical technique, one traditionally used to reconstruct the metacarpophalangeal joint of the thumb, failed to return the three-dimensional position of the proximal phalanx on the metacarpal head of the index finger to normal. The second surgical technique, based on anatomy, returned the position of the proximal phalanx to levels not statistically different from normal for most flexion angles.     

Comparison of results after surgical repair of acute and chronic ulnar collateral ligament injury of the thumb

This study sought to demonstrate that successful outcomes can be achieved with the new technique presented here for chronic ulnar collateral ligament (UCL) injury of the thumb metacarpophalangeal (MCP) joint, as well as with K-wire pinning for acute UCL injury. We followed 19 patients who suffered an UCL rupture (mean follow-up: 14.26 ± 4.65 months) and 32 patients who presented with UCL avulsion fracture (mean follow-up: 16.81 ± 7.54 months). We used a free tendon graft for UCL reconstruction in the UCL rupture group. Both ends of the graft were stabilized with bioabsorbable suture anchors, which were used as biotenodesis interference screws. Closed reduction and K-wire fixation was used in UCL avulsion fracture group. There were no statistically significant differences between operated and contralateral healthy thumb MCP joint in both groups in the grip strength, tip pinch strength, flexion, extension, ulnar deviation, and radial deviation movements at final follow-up. Grip strength, tip pinch strength, ulnar deviation and radial deviation were significantly better in the avulsion group than the rupture group. All patients regained full stability at the MCP joint in avulsion group; 16 patients regained full stability and 3 patients presented with mild laxity (less than 10° laxity) in rupture group. Glickel grading scale used as a functional score was excellent for 30 patients and good for 2 patients in avulsion group; it was excellent for 17 patients and good for 2 patients in rupture group. Our study shows that closed reduction and percutaneous K-wire fixation of acute displaced large UCL avulsion fracture is a simple technique and achieves adequate stability of UCL. For UCL rupture, free tendon reconstruction with bioabsorbable suture anchors provides adequate stability and stable fixation within the tunnels.     

掌侧锁定接骨板与普通接骨板治疗桡骨远端骨折疗效的比较

目的 比较掌侧锁定接骨板与普通接骨板治疗桡骨远端骨折的长期疗效.方法 对2005年9月-2007年11月间,采用切开复位掌侧锁定接骨板或普通接骨板内固定的45例随访资料完整的患者,进行两种疗法的比较.其中23例行锁定接骨板内固定,22例行普通接骨板内固定.按照AO分型:A型11例,B型11例,C型23例.随访内容包括:腕关节活动度(屈曲、背伸、尺偏、桡偏),前臂旋前、旋后活动范围,影像学资料(尺偏角、掌倾角、桡骨高度),应用DASH上肢功能评定标准和Gartland/Wertey腕关节评分法进行评分.结果 术后随访时间平均为18.8个月(12～36个月).腕关节活动度中,锁定板组背伸及两组的桡偏范围低于Gartland/Werley腕关节评分的基本范围.两组DASH值、腕关节活动度及前臂旋转范围,握力、捏力的恢复差异无统计学意义.Gartland/Werley腕关节评分普通接骨板治疗组优于锁定接骨板治疗组,差异有统计学意义.掌倾角均值两组都低于正常范围,尺偏角与桡骨高度均值在正常范围内,两组间差异无统计学意义.结论 掌侧锁定接骨板与普通接骨板在桡骨远端骨折治疗中具有相同疗效.