T形锁定钢板治疗不稳定型桡骨远端骨折42例

目的探讨T形锁定钢板治疗不稳定型桡骨远端骨折的临床效果及体会。方法 2009年6月至2011年12月间,笔者收集了42例复位欠佳的不稳定型桡骨远端骨折病例,按OA分型：A型14侧,B型6侧,C型22侧;陈旧性骨折2例,其余为新鲜骨折;合并正中神经损伤4例,均采用腕掌侧入路T形锁定钢板于桡骨掌侧内固定,术后指导患者进行早期功能训炼,定期复查X线片均示骨折愈合良好,其中1例出现创伤性关节炎,无1例感染或神经、血管及肌腱损伤等并发症发生。结果所有病例均获得随访,按Sarmiento标准进行评定：优31例,良8例,可3例,优良率达92.9%。结论 T形锁定钢板用于治疗不稳定型桡骨远端骨折,具有操作简单、固定牢靠、可早期进行功能锻炼及并发症少等优点,能最大限度地恢复腕关节功能,值得临床推广应用。

42 Cases of Unstable Fractures of the Distal Radius Treated with T Shape Locking Compression Plates

Objective To explore the clinical effect and experience of T shape locking compression plates （LCP） in the treatment of unstable fractures of the distal radius. Methods 42 cases of unstable fractures of the distal radius with imperfect reduction from June 2009 to December 2011 were selected in this study. The OA classification results showed 14 sides of type A, 6 sides of type B and 22 sides of type C. 2 cases were old fractures and others were fresh fractures. 4 cases complicated with median nerve injuries were treated with volar locking compression plate internal fixation, early functional training was taken after operation; the X-ray photograph showed that bone healing was satisfactory; one case occurred with traumatic arthritis and no infection, nerve, blood vessels or tendon injuries were found in all cases. Results All patients were followed up. The assessment by Sarmiento standard was excellent in 31 cases, good in 8 cases, common in 3 cases, with excellent and good rate of 92.9% （39/42）. Conclusions T shape locking compression plate has the advantages of simple operation, stable fixation, early functional exercise and fewer complications in the treatment of unstable fracture of the distal radius, which can maximally recover the wrist joint function and deserves clinical application.