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.

Comparison of treatment outcomes between volar locking compression plate and conventional plate fixation in the treatment of distal radius fractures

Objective To compare the long-term results of treatment of distal radius fractures using LCP (locking compression plate) and conventional plate fixation. Methods From September 2005 to November 2007, 45 eases of distal radius fractures were treated with open reduction and internal fixation with either LCP or conventional plate. Twenty-three cases were treated with LCP while the other 22 with conventional plate.According to AO classification there were 11 type A, 11 type B and 23 type C fractures. These patients were followed up and their results compared. Follow up evaluations included wrist range of motion (flexion, extension,ulnar deviation and radial deviation), forearm pronation and supination, radiographic criteria (radial inclination,volar tilting and radial height), DASH ( Disabilities of the Ann, shoulder, and Hand) score and Garfland/Werley wrist score. Results Postoperative follow up was 18.8 months on average ( 12 to 36 months). Wrist extension in the LCP treated group and radial deviation in both groups were lower than the range defined by the Garfland/Werley criteria. No statistically significant difference was found between the two groups in DASH score, wrist active range of motion, forearm rotation, and grip and pinch strength. Gartland/Werley wrist score was better in patients treated with conventional plate than in those treated with LCP. The difference was statistically significant.Conclusion LCP fixation and conventional plate fixation lead to similar results in the treatment of distal radius fractures.