带变向锁钉掌侧钢板DVRTM在不稳定桡骨远端骨折中的应用

背景：用锁定钉的最终固定依赖于钢板的放置，为避免螺钉锁入关节，要求在放入螺钉前反复确认骨折块的复位及钢板位置的放置，无疑增加了操作繁琐及螺钉进入关节的风险。 目的：观察新型带变向螺钉的解剖型掌侧锁定钢板DVRTM治疗不稳定桡骨远端骨折的疗效。 方法：21例不稳定桡骨远端骨折患者，AO分型A3型3例，B2型3例，B3型2例，C1型3例，C2型5例，C3型5例。受伤后0~12 d采用带变向螺钉的解剖型掌侧锁定钢板DVRTM治疗。 结果与结论：随访至24周时，所有患者均获得骨性愈合，无软组织并发症，无螺钉移位及钢板断裂，影像学及功能评估满意。据此得出，对于不稳定桡骨远端骨折，这种固定方式能提供解剖复位、固定确切、并发症发生率低，钉板之间能更灵活、弹性的搭配。

Variable-angle locking screw volar plating DVRTM in treating unstable distal radius fractures

BACKGROUND: Final fixation of locking nail depends on location of the plate that requires to be repeatedly confirmed before screw implantation to avoid implanting locking screw to the joint. It will lead to complicated operation and increase the risk for screw implantation into the joint. OBJECTIVE: To investigate a novel method in the treatment of unstable distal radius fractures. METHODS: Among 21 cases of unstable distal radius fractures, there were 3 cases of A3, 3 of B2, 2 of B3, 3 of C1, 5 of C2, 5 of C3 according to AO typing. After 0-12 days of injury, the patients received variable-angle locking screw volar plating DVRTM. RESULTS AND CONCLUSION: At 24 weeks of the follow-up, all patients had bone healing, no soft tissue complications, no screw displacement and plate fracture, and satisfactory imaging and functional assessment. Thus obtained, this approach for unstable distal radius fracture can provide anatomical fixation, exact fixation, low complication incidence. In addition, it is more flexible and resilient in the matching between the screw and plate.