Zhou Ziguang, Kwan Kenny, Law T W, Leung Frankie K L
Department of Orthopaedics, Pinggu Hospital of Beijing, Beijing, 101200, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2009 Nov;23(11):1294-7.
To determine the clinical results of locking plate system in the treatment of distal radial fractures.
From May 2004 to November 2006, 75 patients were treated with 2.4 mm locking plate system. There were 41 males and 34 females, with a mean age of 51 years old (range, 13-82 years old). The locations were left side in 34 cases and right side in 41 cases. The cause of injury was a low energy fall in 49 cases, falling from height in 14 cases, traffic accident in 6 cases and sports injuries in 6 cases. All patients were diagnosed as having closed fracture. According to Müller-AO classification, there were 14 cases(18.7%) of type A, 5 cases(6.7%) of type B, and 56 cases(74.6%) of type C. The time from injury to operation was 5 hours to 27 days (mean 6 days).
A total of 75 patients were followed up at 3 months, 71 patients at 6 months, 68 patients at 1 year and 51 patients at 2 years. Healing by first intention of incision was achieved in 73 cases, and infection occurred in 2 cases. Fracture reduction failed at 1 month, 3 months and 6 months in 1 case, respectively; 1 case received plaster fixation and 2 cases received re-fixation and autograft of ilium; and fracture healed in 3 cases at last follow-up. Two patients complained of skin numbness at site of superficial branch of radial nerve after 1 day, 1 patient had wound pain after operation, and 1 patient had infection of tendon at 3 days and 5 days in 1 case respectively. At last follow-up, the ranges of motion of wrist joint were (80 +/- 9) degrees for pronation, (86 +/- 7) degrees for supination, (57 +/- 10) degrees for dorsal flexion, (51 +/- 13) degrees for palmar flexion, (18 +/- 7) degrees for radial inclination, and (28 +/- 7) degrees for ulnar deviation. According to modified Green scoring, the results were excellent in 66 cases, good in 6 cases and poor in 3 cases. At last follow-up, according to Knirk criterion for osteoarthritis, there were 22 cases of grade I and 5 cases of grade II, and all were classified as type C.
Internal fixation of distal radial fractures with 2.4 mm locking plate system provided a stable fixation with good clinical outcomes.
确定锁定钢板系统治疗桡骨远端骨折的临床效果。
2004年5月至2006年11月，75例患者接受2.4mm锁定钢板系统治疗。男性41例，女性34例，平均年龄51岁（范围13 - 82岁）。骨折部位左侧34例，右侧41例。受伤原因：低能量跌倒49例，高处坠落14例，交通事故6例，运动损伤6例。所有患者均诊断为闭合性骨折。根据Müller - AO分类，A型14例（18.7%），B型5例（6.7%），C型56例（74.6%）。受伤至手术时间为5小时至27天（平均6天）。
75例患者均获随访，3个月时75例，6个月时71例，1年时68例，2年时51例。73例切口一期愈合，2例发生感染。分别有1例在1个月、3个月和6个月时骨折复位失败；1例接受石膏固定，2例接受再次固定及髂骨自体植骨；末次随访时3例骨折愈合。2例患者术后1天出现桡神经浅支分布区皮肤麻木，1例术后伤口疼痛，1例分别在术后3天和5天出现肌腱感染。末次随访时，腕关节活动度：旋前（80±9）度，旋后（86±7）度，背伸（57±10）度，掌屈（51±13）度，桡偏（18±7）度，尺偏（28±7）度。根据改良Green评分，优66例，良6例，差3例。末次随访时，根据Knirk骨关节炎标准，Ⅰ级22例，Ⅱ级5例，均为C型。
2.4mm锁定钢板系统内固定治疗桡骨远端骨折固定稳定，临床效果良好。
