Krukhaug Yngvar, Hove Leiv M
Department of Orthopedics, Haukeland University Hospital, NO-5021 Bergen, Norway.
Scand J Plast Reconstr Surg Hand Surg. 2004;38(5):293-6. doi: 10.1080/02844310410029516.
We have used open reduction and internal fixation (ORIF) with the AO pi-plate in 32 displaced, intra-articular fractures of the distal radius. The indication was a displaced intra-articular fracture with a step-off of more than 1 mm and a gap between fragments of more than 3 mm, judged from the primary computed tomograms (CT). All fractures were classified as AO type C3. Twenty-nine patients were followed-up after a mean of 23 (9-46) months. The dorsal tilt, the radial length, the radial inclination, the articular step-off, and the intra-articular gap between fragments were substantially improved postoperatively. All the patients had excellent or good extra-articular and intra-articular alignment. Two patients had reduced extension power of the first finger. Seventeen patients had Disability of the arm, shoulder, and hand (DASH) scores of less than 10 points, five had scores between 11 and 20, three between 21 and 30, three between 31 and 40, and one patient had a score of 65 points. Complications occurred in two patients: one had a painful amputation neuroma of the superficial radial nerve, and one developed adhesions of the flexor tendons of the second and third fingers because the screws were too long and had penetrated the tendon sheaths. We conclude that the AO pi-plate is an excellent option for the most comminuted fractures of the distal radius.
我们采用AO桡骨远端掌侧板对32例桡骨远端移位关节内骨折进行了切开复位内固定（ORIF）。手术指征为根据初次计算机断层扫描（CT）判断，移位关节内骨折台阶超过1mm，骨折块间间隙超过3mm。所有骨折均分类为AO C3型。29例患者平均随访23（9 - 46）个月。术后背侧倾斜、桡骨长度、桡骨倾斜度、关节台阶及骨折块间关节内间隙均有显著改善。所有患者关节外和关节内对线均为优或良。2例患者示指伸展力减弱。17例患者上肢、肩部和手部功能障碍（DASH）评分低于10分，5例评分在11至20分之间，3例在21至30分之间，3例在31至40分之间，1例患者评分为65分。2例患者出现并发症：1例发生桡浅神经痛性截肢神经瘤，1例因螺钉过长穿透腱鞘导致示指和中指屈肌腱粘连。我们得出结论，AO桡骨远端掌侧板是治疗桡骨远端最粉碎性骨折的极佳选择。
