掌侧钢板固定治疗不稳定的背侧移位桡骨远端骨折

掌侧钢板固定治疗不稳定的背侧移位桡骨远端骨折【摘要】 初步探讨掌侧钢板固定治疗不稳定、背侧移位桡骨远端骨折的方法及其效果。［方法］回顾性分析掌侧 LCP 结合克氏针撬拨、植骨等技术治疗不稳定、背侧移位桡骨远端骨折 35 例，比较讨论手术前后掌倾角、尺偏角、桡骨短缩及关节活动范围等，初步评价其临床疗效。［结果］经随访 9～24 个月，掌倾角、尺偏角、桡骨短缩均获明显改善，腕关节功能按Sarmiento 标准评定，优 20 例、良 12 例、可 2 例、差 1 例。［结论］对不稳定、背侧移位桡骨远端骨折，掌侧 LCP 是一种安全有效的治疗方法，可有效防止复位丢失、减少结构性植骨、避开肌腱激惹等并发症。【关键词】 桡骨远端 骨折 内固定 掌侧钢板 Abstract：［Objective］To preliminarily explore the method and evaluate the effect of volar LCP fixation for dorsally displaced and unstable distal radial fractures.［Method］Thirty five patients with the fractures were treated with volar LCP combined with the techniques of K wires and bone grafting, whose effects were evaluated preliminarily through comparing and analyzing the volar tilt, radial inclination, radial shortening and wrist function.［Result］Followed up from 9 to 24 months (average 17months), 20 patients achieved excellent, 12 good and 2 fair with 1 poor, according to Sarmiento scale.［Conclusion］Volar LCP fixation is a safe and effective treatment for unstable and dorsally displaced distal radial fractures, which could prevent reduction lost, reduce need for bone grafting and avoid tendon irritation. Key words：distal radius; fracture; internal fixation; LCP; locking compression plate; volar plate 桡骨远端骨折是最常见的骨折之一，约占全身骨折的 1/6［1］；在恢复关节面平整、桡骨远端高度、掌倾角和尺偏角、维持复位的前提下，加强腕、手关节早期功能康复、以最大限度减少并发症、获得最大功能恢复，仍然是骨科医生的不懈追求。对于背侧移位的不稳定桡骨远端骨折、尤其存在背侧骨皮质粉碎、骨缺损不能提供应力侧支柱者，治疗上仍具挑...