Department of Orthopedic Surgery, Tohoku Kosai Hospital, Sendai, Japan.
Ups J Med Sci. 2011 Nov;116(4):280-4. doi: 10.3109/03009734.2011.594183. Epub 2011 Jun 27.
Open reduction and internal fixation using an interlocking plate system has gained popularity for the treatment of dorsally displaced distal radius fractures.
To evaluate the functional and radiological results of treating unstable distal radius fractures with the volar locking plate.
A retrospective review was conducted of patients from one institution using the volar locking plate to treat intra-articular and extra-articular distal radius fractures. Unstable distal radius fractures in 15 patients, comprising 3 men and 12 women with a mean age of 64.4 years (34-76 years), were treated with a volar locking compression plate (Acu-Loc distal radius plate system; Acumed, Oregon, USA) and followed up for a minimum of 1 year. Fractures were classified using the AO classification. Radiographic parameters of preoperative, postoperative, and final follow-up radiographs were compared. The time to initiation of active range of motion was determined. Final follow-up range of motion and complications were reported.
At final functional assessment, the scores of 5 patients were excellent, 7 patients good, and 3 patients fair according to Cooney's Clinical Scoring Chart. No non-union or infection occurred. Rupture of the flexor pollicis longus tendon occurred in 1 patient.
Treatment of unstable distal radius fractures with a volar locking plate leads to satisfactory results, provided the operative technique is carefully performed to prevent complications.
使用带锁钢板的切开复位内固定已广泛应用于治疗背侧移位的桡骨远端骨折。
评估掌侧锁定钢板治疗不稳定型桡骨远端骨折的功能和影像学结果。
对单中心使用掌侧锁定钢板治疗关节内和关节外桡骨远端骨折的患者进行回顾性研究。15 例不稳定型桡骨远端骨折患者,3 例男性,12 例女性,平均年龄 64.4 岁(34-76 岁),使用掌侧锁定加压钢板(Acu-Loc 桡骨远端钢板系统;AcuMed,俄勒冈州,美国)治疗,并至少随访 1 年。骨折采用 AO 分类。比较术前、术后和最终随访的影像学参数。确定主动活动范围开始的时间。报告最终随访时的活动范围和并发症。
根据 Cooney 临床评分表,最终功能评估时,5 例患者评分优秀,7 例患者评分良好,3 例患者评分尚可。无不愈合或感染发生。1 例患者发生拇长屈肌腱断裂。
掌侧锁定钢板治疗不稳定型桡骨远端骨折可获得满意的结果,但应仔细操作手术以预防并发症。