Georgoulis A, Lais E, Bernard M, Hertel P
Universitätsklinikum Rudolf Virchow, Abteilung für Traumatologie, Berlin.
Aktuelle Traumatol. 1992 Feb;22(1):9-14.
28 patients with a fracture of the distal end of the radius were treated by a T-plate osteosynthesis through the volar approach. There were 7 unstable distal metaphyseal fractures and 21 dislocated intra-articular fractures. 21 patients were investigated 6 months to 8 years after operation according to the scheme of Sarmiento. 17 patients had a good or excellent result, 4 patients a fair or poor result. 2 patients developed a Sudeck's dystrophy (Algodystrophy), one of them with a radial-ulnar bone bridge. The volar application of the plate is indicated for flexion and extension fractures. In cases with compression of the dorsal cortex a bone graft is indicated to improve a stable osteosynthesis. A conventional tomography on two views helps to diagnose exactly an intra-articular fracture and to decide whether to use a plate or pins and external fixation after open reduction. Remanipulation or an operation 2 weeks after trauma increases the risk of a Sudeck's dystrophy and leads to a poor result.
28例桡骨远端骨折患者采用掌侧入路T形钢板内固定治疗。其中有7例不稳定的干骺端骨折和21例关节内脱位骨折。按照Sarmiento方案对21例患者在术后6个月至8年进行了随访。17例患者结果为优或良，4例患者结果为可或差。2例发生了苏戴克氏营养不良（痛性营养不良），其中1例伴有桡尺骨桥形成。钢板掌侧应用适用于屈曲和伸展型骨折。对于背侧皮质受压的病例，需植骨以促进稳定的内固定。常规的双视图断层扫描有助于准确诊断关节内骨折，并决定在切开复位后是使用钢板还是克氏针及外固定。伤后2周再次手法复位或手术会增加发生苏戴克氏营养不良的风险，并导致预后不良。
