目的:评估使用锁定钢板治疗桡骨远端不稳定骨折的疗效。方法:2005年8月至2009年5月使用锁定钢板治疗桡骨远端不稳定性骨折27例。平均553岁。按AO分类:B2型5例,B3型2例,C1型11例,C2型7例,C3型2例。结果:全部病例得到3～24个月随访,平均162个月。根据Fernandez评分标准进行腕关节功能评分:优14例,良10例,一般1例,差2例。优良率875％。 结论:掌侧锁定钢板治疗桡骨远端不稳定性骨折是安全有效的治疗选择,可提供坚强的固定,早期功能训练。
Objective To investigate the operative indication and clinical efficacy of combination of external fixator and volar approach fixation in treatingdistal radius fracture. Methods From March 2000 to March 2005, 28 patients with distal radius fracture were treated with combination of external fixator and volar approach fixation. Dorsal external fixator was used to maintain wrist in functional position, combinated volar plate or Kirschner wire fixation after reduction was achieved. Bone graft was necessary if there were severe comminuted cortical bone or compress of cancellous bone. Of 28 patients, there were 21 males and 7 females, aging from 1854 years with a median age of 41 years. The locations were the left side in 4 cases and the right side in 24 cases. According to typing criterion for AO, 18 cases were classified as C2 and 10 cases as C3. One case wasaccompanied with dislocation of lunate bone. Results Among 28 patients, 24 were followed up for an average of 8.5 months. The anatomical relationship of their wristjoint were reestablished and retained. Overall good to excellent results were achieved in 87%, excellent in 16 cases, good in 5 cases and fair in 3 cases. Conclusion A combination of external fixator and volar approach fixation is an effective method of treating fractures of the distal radius，because distal radius fracture is unstable or difficult to close reduction. Volarfixation can avoid operative complication, and external fixator can obtain satisfactory reduction and function.