Rein Susanne, Schikore Hartmut, Schneiders Wolfgang, Amlang Michael, Zwipp Hans
Carl Gustav Carus University Hospital of Dresden, Department of Trauma and Reconstructive Surgery, Dresden, Germany.
J Hand Surg Am. 2007 Sep;32(7):954-61. doi: 10.1016/j.jhsa.2007.05.008.
The aim of this study was to define the outcome after dorsal or volar plating of Association for Osteosynthesis (AO) type C3 distal radius fractures based on the fracture morphology.
Twenty-nine patients with AO type C3 distal radius fractures were surgically managed between 1996 and 2005. Group 1 (n = 15) had volar plating. Group 2 (n = 14) had dorsal plating. Outcomes were evaluated at an average of 22 months after surgery. Statistical analysis was performed using the Wilcoxon test and chi-square test.
No significant differences were seen for the scores of Gartland and Werley, Castaing, Stewart I and II, Green and O'Brien, and Disability of the Arm, Shoulder and Hand between the 2 groups. The visual and verbal pain analog scales did not show significant differences between the 2 groups. Radiology analysis showed significant difference in comparison with the contralateral side in terms of dorsopalmar inclination (3 degrees +/- 3) and distal radioulnar joint angle (98 degrees +/- 8) for the patients in group 1, whereas there were no significant differences in group 2. The development of radiographic post-traumatic arthritis was significant in both groups. Significant functional differences were seen for flexion (45 degrees +/- 15) and hand span (20 cm +/- 2) in group 1 as well as for extension (37 degrees +/- 19), flexion (42 degrees +/- 12), and radial deviation (16 degrees +/- 10) in group 2. We found more complications after dorsal plate osteosynthesis than after volar plate osteosynthesis.
This study shows satisfactory functional and subjective outcome results in both groups. Group 1 had non-significant better functional results than group 2, whereas both groups showed good to very good radiology results.
本研究旨在根据骨折形态确定采用骨合成协会（AO）C3型桡骨远端骨折背侧或掌侧钢板固定后的疗效。
1996年至2005年间，对29例AO C3型桡骨远端骨折患者进行了手术治疗。第1组（n = 15）采用掌侧钢板固定。第2组（n = 14）采用背侧钢板固定。术后平均22个月对疗效进行评估。采用Wilcoxon检验和卡方检验进行统计学分析。
两组在Gartland和Werley评分、Castaing评分、Stewart I和II评分、Green和O'Brien评分以及手臂、肩部和手部功能障碍评分方面均无显著差异。两组的视觉和言语疼痛模拟量表评分也无显著差异。影像学分析显示，第1组患者的掌背倾角（3°±3）和桡尺远侧关节角（98°±8）与对侧相比有显著差异，而第2组无显著差异。两组创伤后关节炎的影像学表现均较明显。第1组在屈曲（45°±15）和掌指距（20 cm±2）方面存在显著功能差异，第2组在伸展（37°±19）、屈曲（42°±12）和桡偏（16°±10）方面存在显著功能差异。我们发现背侧钢板固定术后的并发症比掌侧钢板固定术后更多。
本研究表明两组的功能和主观疗效结果均令人满意。第1组的功能结果略优于第2组，但两组的影像学结果均为良好至非常好。
