背侧双锁定加压钢板治疗桡骨远端伸直型不稳定骨折

摘要

Objective To evaluate the outcome of dorsal double locking compression plate (LCP) in treatment of stretched unstable distal radial fractures.Methods Fourteen cases of stretched unstable distal radial fractures were treated by reduction and internal fixation using straight or L-shaped anatomic LCP via dorsal approach.Wrist functional exercise was conducted immediately after operation.Follow up was made after operation to assess motion pain,functional score of wrist,and complication incidence at postoperative 12 weeks,24 weeks,and 1 year.Results Follow-up was lasted for 5-24 months.At postoperative 12 weeks,24 weeks and 1 year,mean visual analogue scale (VAS) was (1.88 ±0.26) points,(0.87 ± 0.14) points and (0.37 ± 0.06) points respectively and wrist functional score (Gartland-Werley score) was (6.45 ± 1.72) points,(2.73 ± 0.52) points and (2.10 ± 0.31) points respectively.According to Garfland-Werley score in the latest follow-up,the results were excellent in 10 cases,good in two,and fair in two.Besides,one case was combined with myotenositis of extensor pollicis longus muscle tendon and another case with myotenositis of extensor tendon.Conclusion Dorsal double LCP is one of the effective methods for stretched unstable distal radial fractures that can reconstruct anatomical structure of the wrist efficiently and attain satisfactory functional recovery,with no obvious pain.%目的 评价背侧双锁定加压钢板(locking compression plate,LCP)对桡骨远端伸直型不稳定骨折的治疗效果. 方法 14例桡骨远端伸直型不稳定骨折,采用背侧入路,骨折复位后用解剖型直形和“L”形LCP固定.术后早期开始腕关节动能锻炼.随访评价术后12,24周、1年的活动痛和腕关节功能评分及并发症的发生率. 结果 随访5～24个月,术后12,24周,1年活动时的视觉模拟评分(visual analogue scale,VAS)分别为(1.88±0.26)分、(0.87±0.14)分、(0.37±0.06)分；腕关节功能评分(Gartland-Werley评分)分别为(6.45±1.72)分、(2.73±0.52)分、(2.10±0.31)分.终末随访时Gartland-Werley评分:优10例,良2例,可2例.并发拇长伸肌腱炎和指伸肌腱炎各1例. 结论 背侧双LCP治疗桡骨远端伸直型不稳定骨折可有效恢复腕关节的解剖结构,无明显活动痛,术后功能恢复满意,是治疗桡骨远端骨折的有效方法之一.