Nalbantoğlu Ufuk, Gereli Arel, Uçar Yavuz, Türkmen Metin
Department of Orthopedics and Traumatology, Hand and Upper Extremity Surgery (Ortopedi ve Travmatoloji Bölümü, El ve Ust Ekstremite Cerrahisi Servisi), Acibadem Kadiköy Hospital, Istanbul, Turkey.
Acta Orthop Traumatol Turc. 2008 Nov-Dec;42(5):365-72. doi: 10.3944/aott.2008.365.
We compared the results of fixation with dorsal T plate and palmar locking plate in the treatment of unstable displaced distal radius fractures.
Sixty-three patients (64 radii) with distal radius fractures were treated with dorsal T plate (n=41) or palmar locking plate (n=23). The mean age was 46+/-14 years (range 21 to 82 years) in the dorsal and 47+/-14 years (range 18 to 69 years) in the palmar plate groups. The fractures were classified according to the AO/ASIF system. Objective and subjective functional assessments were made using the Gartland-Werley and Quick-DASH scales, respectively. The mean follow-up was 78+/-19 months (range 12 to 101 months) and 18+/-5 months (range 12 to 28 months) with dorsal and palmar plating, respectively.
The mean Gartland-Werley and Quick-DASH scores were 2.3+/-2.1 (range 0 to 9) and 2.0+/-2.2 (range 0 to 9) with dorsal plating, and 2.0+/-2.1 (range 0 to 6) and 1.9+/-2.7 (range 0 to 9) with palmar plating, respectively. The two groups did not differ with respect to the Gartland-Werley and Quick-DASH scores (p>0.05). Time to return to work or daily activities was also similar (1.9+/-0.3 months vs 1.8+/-0.4 months). However, patients treated with dorsal plating exhibited significantly greater values in the following parameters measured on early and late postoperative radiograms: loss of palmar tilt (p=0.001), radial height (p=0.001), radial inclination (p=0.049), and change in ulnar variance (p=0.049). Moreover, complications were seen in eight patients (19.5%) with dorsal plating, whereas no complications occurred with palmar locking plate (p=0.024).
Although the two fixation methods do not differ with respect to functional results, palmar locking plating seems to provide a more rigid fixation resulting in significantly reduced collapse and a very low complication rate.
我们比较了使用背侧T型钢板和掌侧锁定钢板固定治疗不稳定移位桡骨远端骨折的结果。
63例（64侧桡骨）桡骨远端骨折患者接受了背侧T型钢板（n = 41）或掌侧锁定钢板（n = 23）治疗。背侧钢板组患者平均年龄为46±14岁（范围21至82岁），掌侧钢板组为47±14岁（范围18至69岁）。骨折根据AO/ASIF系统进行分类。分别使用Gartland-Werley和Quick-DASH量表进行客观和主观功能评估。背侧钢板固定和掌侧钢板固定的平均随访时间分别为78±19个月（范围12至101个月）和18±5个月（范围12至28个月）。
背侧钢板固定的平均Gartland-Werley评分和Quick-DASH评分分别为2.3±2.1（范围0至9）和2.0±2.2（范围0至9），掌侧钢板固定的分别为2.0±2.1（范围0至6）和1.9±2.7（范围0至9）。两组在Gartland-Werley评分和Quick-DASH评分方面无差异（p>0.05）。恢复工作或日常活动的时间也相似（1.9±0.3个月对1.8±0.4个月）。然而，接受背侧钢板固定的患者在术后早期和晚期X线片测量的以下参数中显示出明显更大的值：掌倾角丢失（p = 0.001）、桡骨高度（p = 0.001）、桡骨倾斜度（p = 0.049）和尺骨变异改变（p = 0.049）。此外，8例（19.5%）接受背侧钢板固定的患者出现并发症，而掌侧锁定钢板固定未出现并发症（p = 0.024）。
虽然两种固定方法在功能结果方面无差异，但掌侧锁定钢板固定似乎能提供更牢固的固定，导致塌陷明显减少且并发症发生率极低。
