外固定架加掌侧钢板治疗桡骨远端关节内粉碎性骨折

[目的]探讨外固定支架结合掌侧钢板内固定治疗桡骨远端关节内粉碎性骨折的疗效。[方法]自2004年2月~2008年2月采用外固定支架结合掌侧钢板内固定治疗桡骨远端关节内粉碎性骨折35例。男23例,女12例:平均年龄41.6岁。按AO/ASIF分型均为C3型。其中闭合性骨折30例,开放性骨折5例。[结果]术后随访24~118个月,平均37个月,35例骨折均获得愈合。术后1年随访,32例关节面台阶2mm,3例关节面台阶2mm;平均桡骨高11.11mm(8~15mm);平均掌倾角8.37°(-5~20°);平均尺偏角21.83°(13~25°)。与健侧相比,尺偏角、桡骨高的差异无统计学意义(P0.05),掌倾角较健侧相比平均丢失了2.69°,差异有显著性意义(P0.05)。根据Gartland-Werley腕关节评分标准,优良率为91%。[结论]外固定支架结合切开复位掌侧钢板内固定治疗桡骨远端关节内粉碎性骨折效果满意,病人腕关节、前臂及手的功能恢复好,术后创伤性骨关节炎的发生率低,并发症少,病人主观满意率高,是目前比较安全有效的方法。

Treatment of comminuted intra-articular fractures of the distal radius by open reduction and combined volar plate and external fixation

[Objective]To appraise the therapeutic effect of treatment of comminuted intra-articular fractures of the distal radius by open reduction and combined volar plate and external fixation.[Method]Thirty-five consecutive patients with comminuted intra-articular fractures of the distal radius underwent the treatment by open reduction and combined volar plate and external fixation from February 2004 to February 2008.Of them,23 were male and 12 were female,with an average age of 41.6 years.According to AO/ASIF cla...