【作者】 齐新文； 王兆杰； 安荣泽； 陈军平； 叶小聪； 方存迅；

【Author】 Qi xin-wen,Wang zhao-jie,An rong-ze,Chen jun-ping,Ye xiao-cong,Fang cun-xunDepartment of orthopaedics surgery, the fifth affliated hospital of zunyi medical college,Guangdong Zhuhai 519100

【机构】 遵义医学院第五附属医院骨科；

【摘要】 目的:应用掌侧钢板治疗背侧移位的桡骨远端粉碎骨折,评估重建后的桡腕关节的完整性稳定性及功能的恢复。方法:2006年9月至2009年1月,经掌侧入路治疗23例背侧移位的桡骨远端粉碎性骨折,按Coony分型,Ⅲ型4例,ⅣA型8例,ⅣB型6例,ⅣC型5例;其中2例为开放性骨折,Gustino-Ⅰ度。比较掌倾角、尺偏角及桡骨长度的恢复,评定腕关节功能。结果:经过5—32月的随访,平均14.6月。掌倾角、尺偏角及挠骨短缩的长度恢复良好,腕关节功能按Sarmiento标准评定,优14例、良6例、可2例、差1倒,优良率86.9%。无正中神经损伤、肌腱磨损及医源性桡动脉瘤形成等并发症。结论:掌侧钢板治疗背侧移位的桡骨远端骨折具有有效防止复位丢失、避免肌腱磨损、早期功能锻炼等优点,是一种简单有效安全的治疗方法。更多还原

【Abstract】 Objective To treat dorsally displaced distal radial fractures via palmar approach and to assess the integrity and sta- ble fixation and the function of radiocarpal jion.Methods Twenty - three cases patients with dorsally displaceddistal radial fractures were performed operatively with open reduction and internal fixation via palmar approach between Sept 2006 and Jan 2009,Accordingto the Coony classification,4 cases were of typeⅢ,8 caseswere ofⅣA,6 cases were ofⅣB and 5 cases were ofⅣC.2 of 23 cases were open - fracture and belong to degree Gustino -Ⅰ.the patient effects were evaluated preliminarily through comparing and analyzing the volar tilt,radial inclination,radial shortening and wrist function.Results All cases were followed - up,and the follow -up time was averagely 14.6 months ranging from 5 to 32 months.According to Sarmiento criteria 14 cases were rated as excellent (60.8%),6 cases as good(26.1%),2 cases as fair and 1 as poor,and the excellent-good rate was86.9%.Medianus nerve injury as well as tendon injury and radia anterum were not found.Conclusion This palmar approach and fixation is a simple and safe and effective treatment for the dorsally displaced distal radial fractures,which could prevent reduction lost,avoid tendon irritation and early functional training.更多还原