Heim D
Chirurgische Abteilung, Spital Frutigen.
Swiss Surg. 2000;6(6):304-14. doi: 10.1024/1023-9332.6.6.304.
From 1.1.95 to 31.12.98 133 distal radius fractures were treated surgically. Internal fixation with a plate was carried out in 34 fractures (25%). 17 plates were placed dorsally, 16 plates on the volar aspect and one fracture was treated with a combined dorsal and volar plate. 29/34 fractures (87%) were reviewed 1 year after surgery. All fractures healed without further surgery. No infection occurred. 15 implants were removed. 23/29 (79%) internal fixations showed a good or excellent result, 6/29 (21%) a fair result. These 6 patients had in common: an intraarticular fracture (5), a volar tilt (5), a postoperative algodystrophy (5) or a secondary dorsal displacement (2).
One fourth of all surgically treated distal radius fractures underwent plate osteosynthesis with about 80% of good or excellent results. Dorsal plate osteosynthesis showed better results than volar plate fixation. An additional, temporary external fixator in fractures with radial shortening proved a reliable help intraoperatively. Secondary displacement in these fractures did not occur.
从1995年1月1日至1998年12月31日，对133例桡骨远端骨折进行了手术治疗。34例骨折（25%）采用钢板内固定。17块钢板置于背侧，16块钢板置于掌侧，1例骨折采用背侧和掌侧联合钢板治疗。术后1年对29/34例骨折（87%）进行了复查。所有骨折均愈合，无需进一步手术。未发生感染。取出了15枚内固定物。23/29（79%）的内固定显示效果良好或极佳，6/29（21%）效果一般。这6例患者的共同特点是：关节内骨折（5例）、掌倾角（5例）、术后反射性交感神经营养不良（5例）或继发背侧移位（2例）。
所有接受手术治疗的桡骨远端骨折中，四分之一接受了钢板接骨术，约80%的效果良好或极佳。背侧钢板接骨术的效果优于掌侧钢板固定。对于伴有桡骨短缩的骨折，额外使用临时外固定架在术中证明是可靠的辅助手段。这些骨折未发生继发移位。
