支撑钢板治疗桡骨远端不稳定骨折

目的探讨桡骨远端不稳定骨折切开复位支撑钢板内固定治疗的疗效。方法对2001年1月至2005年9月通过手术治疗的桡骨远端不稳定骨折26例病例进行回顾性分析。按AO分型为C2或C3型,采用支撑钢板掌侧固定17例,背侧固定9例。结果26例患者全部获得随诊,握力恢复平均为对侧的78%,11例腕关节伸屈活动达健侧的70%~80%,4例背伸及掌屈均只达健侧的60%~80%,3例活动度在健侧60%以下。23例屈伸活动时无疼痛,3例有轻度疼痛。患者对手术后腕关节功能满意者21例(80.78%),较满意者4例(15.36%),不满意1例(3.86%)。按改良G reen和O’brien标准,18例患者(69.2%)为优,5例(19.2%)为良,3例(11.6%)为一般,优良率88.4%。结论切开复位支撑钢板内固定治疗桡骨远端不稳定疗效好,并发症少,术后配合合理的康复锻炼,能使腕关节功能达到最大的恢复。

Treatment of unstable fracture of distal radius with supporting plate

Objective To evaluate the clinical outcome of surgical treatment of unstable fractures of distal radius with supporting plate.Methods Twenty-six cases of unstable fractures of distal radius admitted to our hospital from January 2001 to September 2005 underwent surgical treatment.According to AO classification,all cases were C2 or C3,in whom seventeen applied palmar fixation,9 dorsal fixation.Results All 26 patients were followed up regularly.The grasp force of all patients recovered to 78% of the contralateral hand.The extension and flection of the affected wrist joint recovered to 70%-80% of the healthy counterpart in 11 patients,the extension backward and palmer flection of the affected wrist only to 60% to 80% in 4 patients,the range of motion lower than 60% of the contralateral part in 3 patients.Twenty-three patients felt no pain at the activity of extension and flection,but 3 flet slight pain.According to AO evaluation of the wrist joint movement,80.8%(21/26) patients had satisfactory functional outcome,15.4%(4/26) had so-so results and 3.8%(1/26) had unsatisfactory functional outcome.Conclusion Open reduction and internal fixation with the supporting plate for unstable fractures of the distal radius is not only an effective method with fewer complications.Early functional exercise is equally impentant for best recovery of wrist function.