Chen Ming, Dong Qirong, Huang Xiao, Zhu Guang, Zhang Zhihong, Min Yan
Department of Orthopaedics and Traumatology, First Affiliated Hospital, Nanchang University, Nanchang Jiangxi 330006, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2009 Nov;23(11):1298-301.
To evaluate the effects of T-shaped plate internal fixation in treatment of intra-articular fracture of distal radius.
From January 2005 to March 2008, 52 cases of intra-articular fracture of distal radius were treated, including 32 males and 20 females and aging 21-60 years old (mean 47 years old). Fracture was caused by tumbling in 30 cases, by falling from height in 8 cases, by traffic accident in 11 cases, and by a crashing object in 3 cases. Of 52 cases, there were 50 cases of closed fracture and 2 cases of open fracture. According to AO standard of classification, there were 14 cases of B2 type, 16 cases of B3 type, 15 cases of C1 type, 6 cases of C2 type, and 1 case of C3 type. According to the Cooney's general standard of classification of unstable fracture, there were 5 cases of type II, 10 cases of type III, and 37 cases of type IV. The time from injury to operation was 3-14 days (mean 5 days). All patients received open reduction and T-shaped plate fixation. Seven patients having bone defect were given 6-15 g autologous ilium or 5 mL calcium sulphate artificial aggregate after reduction.
All incisions healed by first intention. All the patients were followed up for 15 to 30 months postoperatively (mean 24 months). The X-ray films showed good anatomical reduction, even articular surface and no loosening of internal fixation in all the cases. The fractures healed within 9-15 weeks after operation (mean 12 weeks). At last follow-up, the mean palmar tilt was 8 degrees and the mean ulnar variance was 21 degrees, showing statistically significant differences when compared preoperation (-5 degrees and 5 degrees, P < 0.05). The radial length were not abbreviated. According to Dienst assessment, the results were excellent in 42 cases, good in 3 cases, fair in 5 cases and poor in 2 cases 12 weeks after operation, and the excellent and good rate was 86.5%.
T-shaped plate fixation is reliable and effective in treatment of intra-articular fracture of distal radius because it has less complication of infection, loosening of internal fixation, reduction failure and tendon rupture.
评估T形钢板内固定治疗桡骨远端关节内骨折的效果。
2005年1月至2008年3月，治疗52例桡骨远端关节内骨折患者，其中男性32例，女性20例，年龄21 - 60岁（平均47岁）。骨折原因：跌倒30例，高处坠落8例，交通事故11例，重物砸伤3例。52例中，闭合性骨折50例，开放性骨折2例。按AO分类标准：B2型14例，B3型16例，C1型15例，C2型6例，C3型1例。按Cooney不稳定骨折总体分类标准：Ⅱ型5例，Ⅲ型10例，Ⅳ型37例。受伤至手术时间为3 - 14天（平均5天）。所有患者均行切开复位及T形钢板固定。7例有骨缺损患者复位后给予自体髂骨6 - 15 g或硫酸钙人工骨粒5 mL。
所有切口均一期愈合。所有患者术后随访15至30个月（平均24个月）。X线片显示所有病例均解剖复位良好，关节面平整，内固定无松动。骨折术后9 - 15周愈合（平均12周）。末次随访时，平均掌倾角为8°，平均尺骨变异为21°，与术前（-5°和5°）相比差异有统计学意义（P < 0.05）。桡骨长度未缩短。根据Dienst评估，术后12周时，优42例，良3例，可5例，差2例，优良率为86.5%。
T形钢板固定治疗桡骨远端关节内骨折可靠有效，因为其感染、内固定松动、复位失败及肌腱断裂等并发症较少。
