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.

Barton fractures treated by π-shaped locking compression plates

Objective To discuss the effects, indications and methods of π-shaped locking com-pression plates plus open reduction for Barton fractures. Methods From January 2006 to January 2007, 21 cases of Barton fractures were treated by open reduction from dorsal incision and fixation by π-shaped locking compression plates. Of them, 14 also had bone grafting and 6 had protection by a plaster brace. Results Follow-ups for 6 to 18 (average, 10) months showed all the patients got bone union. The differences between preoperative and postoperative measurements in palmar inclination, ulnar deviation and relative length of distal radius were statistically significant (P < 0.05). At the last follow-up, the affected wrist showed no significant difference from the opposite side in dorsal extension, palmar flexion and ulnar deviation (P > 0.05) except in ulnar deviation (P < 0.05). According to the improved Gartland and Werkey grading system, the wrist function was evaluated as excellent in 15 eases, good in 4, and fair in 2. The good to excellent rate was 90. 5%. Conclusion Open reduction from dorsal incision and fixation by π-shaped locking compression plate is an effective treatment for Barton fractures.