解剖型钢板在四肢近关节端骨折中的临床应用

目的 介绍一种四肢近关节端骨折的新型内固定方法，并观察其临床应用效果。方法 46例(52个部位)中，肱骨近端骨折7例，远端4例，桡骨远端骨折3例，股骨近端骨折12例，远端骨折4例，胫骨近端骨折14例，远端骨折8例。均采用解剖型钢板内固定。结果 随访40例，3．5～22个月，平均7．3个月；骨折愈合时间1．6～4．6个月，平均2．5个月。无不愈合，内固定松动、折断、弯曲及感染等并发症。膝关节按照Merchant评分标准，其它部分骨折按照自行拟定骨折愈合的评分标准。本组优26例，良11例，可2例，差1例，总优良率92．5％。结论 解剖钢板因其特有的解剖构型，具有利于复位、固定牢靠及手术简单的优点，对近关节端骨折的复位和固定有良好效果，可早期功能锻炼，值得推广临床应用。

Clinic application of anatomical steel plate in treatment of fractures near extremity joint

Objective To introduce a new internal fixation method for fractures near extremity joint. Methods 46 cases (52 locations) of fractures near extremity joint were treated by internal fixation with anatomical steel plate from June 2001 to January 2003 in our department. Of them, 7 were proximal humeral fractures, 4 distal humeral fractures, 3 distal radius fractures, 12 proximal fractures, 4 distal femoral fractures, 14 proximal tibial fractures, and 8 distal tibial fractures. Results 40 cases were followed up for 3.5 to 22 months (averaging 7.3 months). The healing time of fracture was 1.6 to 4.6 months (averaging 2.5 months) without loosening, breaking or bending of internal fixators, infection or other complications. The knee joint function was evaluated accorded to the Merchant scoring system, and other fractures accorded to self-made scoring systems. The results were excellent in 26 cases, fine in 11, fair in 2, and poor in 1, with the total excellent and fine rate being 92.2%. Conclusion With its special structure, anatomical steel plates can facilitate reduction, provide simple operation but solid fixation, and allow patients to do early functional exercises, so they are worthy of recommendation for the clinical treatment of fractures near extremity.