解剖型掌侧锁定接骨板dvrtm固定不稳定性桡骨远端骨折的疗效分析.docVIP

解剖型掌侧锁定接骨板DVRTM固定不稳定性桡骨远端 骨折的疗效分析 纪斌 曹成福 成翔宇 唐桐生 樊海峰 庞金辉 （上海中医药大学附属普陀医院 骨科，上海，200062） 摘要: 目的 探讨解剖型掌侧锁定接骨板DVRTM在不稳定性桡骨远端骨折中的治疗效果。方法 2010.7 -2012.6期间，我院共67例不稳定性桡骨远端骨折采用切开复位解剖型掌侧锁定接骨板DVRTM内固定术。按照AO分型，其中A3型11 例，B2 型4 例，B3 型2例， C1 型15 例，C2 型23 例，C3 型12 例。结果 所有病例均得到随访，平均12.6±3.2个月，67例患者骨折全部愈合，平均愈合时间为8.7周。改良的sarmiento系统评估骨折复位优良率为95.5 %（64例）。X射线片显示平均桡骨高度为10.3±2.1 mm，平均掌倾角为8.5±4.2°，平均尺偏角21.1±4.9°。采用Dienst标准评估腕关节功能，优良率达92.5 %。结论 切开复位解剖型掌侧锁定接骨板DVRTM内固定术治疗不稳定性桡骨远端骨折的效果令人满意。 关键词: 桡骨远端；骨折；锁定接骨板；掌侧接骨板；疗效分析 Analysis of curative efficiency of unstable distal radius fracture treated by anatomic volar locking plate JI Bin, CAO Cheng-fu, CHENG Xiang-yu, TANG Tong-sheng, FAN Hai-feng, PANG Jin-hui* Corresponding author：PANG Jin-hui, pjhmc@163.com (Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 20006) Abstract: Objective To evaluate the radiologic and functional outcome following internal fixation of unstable distal radius fractures with anatomic volar locking plate. Methods From 2010.7 to 2012.6, 67 patients underwent closed reduction and internal fixation with anatomic volar locking plate. These comminuted distal radius fractures included 11 type A3, 4 type B2, 2 type B3, 15 type C1, 23 type C2, and 12 type C3, according to the AO/ASIF classification. Results All fractures healed with average time of 8.7 weeks. According to the sarmiento criteria, the results were excellent and good in 95.5% and fair in 4.5%. For functional assessment, the patients were assessed using the Dienst scale, with the result of excellent and good in 92.5%. Conclusion Closed reduction and internal fixation with anatomic volar locking plate is an effective method of treatment for unstable distal radius fractures. Key Words: Distal radius fracture；Fracture fixation, internal；Locking plate 桡骨远端骨折指距桡腕关节面3 cm以内的桡骨骨折，据文献报道，其发生率约占前臂骨折的74.5% []，以女性居多。临床上，采用手法闭合复位、石膏固定治疗稳定性桡骨远端骨折，常可取得理想的疗效；但传统的石膏、夹板在治疗严重粉碎性的桡骨远端骨折时，常会出现骨折复位再丢失的情况，从而导致畸形愈合、腕关节活动受限、疼痛无力等并发症。我院于2010.7 -2012.6期间采用掌侧入