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传统 AO 钢板治疗 C 型桡骨远端骨折:在锁定钢板时代,一种简单且经济的解决方案。

Type C distal radial fractures treated with conventional AO plates: an easy and cost-saving solution in a locking plate era.

机构信息

Department of Trauma, University Medical Centre Utrecht, Utrecht, The Netherlands.

出版信息

Int Orthop. 2013 Mar;37(3):483-8. doi: 10.1007/s00264-012-1761-9. Epub 2013 Jan 11.

Abstract

PURPOSE

C-type distal radial fractures remain challenging fractures. Currently locking plates are very popular because of their length preserving, stability. A considerable drawback is the high cost. Since 2003 we have been using mini AO plates (2.7 mm) as an alternative. We analysed our results and performed a cost analysis.

METHODS

Retrospective analysis was performed of all patients operated upon between 2003 and 2008 for C type distal radius fractures. Reduction was achieved with mini AO plates, applied in a buttress fashion, with ligamentotaxis. Rehabilitation consisted of immediate mobilisation. Pre- and postoperative X-rays, operative results and patient charts were reviewed. Furthermore, we prospectively evaluated the functional results using VAS, DASH and Mayo wrist scores. Lastly, we assessed the implant costs and compared them to locking plates.

RESULTS

Thirty-four patients were treated with a mean age of 49 years. Mean radial shortening improved 2 mm; dorsal and radial angulation improved 23 and 4°, respectively. At consolidation (eight weeks) the average radial shortening was 0.75 mm, a volar angulation of 3°, and 21° of radial angulation. Functional results were excellent, demonstrated by a mean VAS score less than 1, a DASH score of 12 and a Mayo wrist score of 87. Compared to locking plates, there was an overall reduction in material costs of 15,300 Euro.

CONCLUSIONS

Our technique has excellent biomechanical stability, enabling immediate functional rehabilitation, good anatomical and functional outcome with significantly lower costs.

摘要

目的

C 型桡骨远端骨折仍然是具有挑战性的骨折。目前,锁定板因其长度保留和稳定性而非常受欢迎。一个相当大的缺点是成本高。自 2003 年以来,我们一直使用微型 AO 板(2.7mm)作为替代。我们分析了我们的结果并进行了成本分析。

方法

对 2003 年至 2008 年间所有接受 C 型桡骨远端骨折手术的患者进行回顾性分析。使用微型 AO 板实现复位,采用支撑式固定,结合韧带固定。康复包括立即活动。评估术前和术后 X 光片、手术结果和患者病历。此外,我们还使用 VAS、DASH 和 Mayo 腕关节评分前瞻性评估功能结果。最后,我们评估了植入物的成本,并将其与锁定板进行了比较。

结果

34 例患者的平均年龄为 49 岁。桡骨缩短平均改善 2mm;背侧和桡侧成角分别改善 23°和 4°。在愈合期(8 周),平均桡骨缩短为 0.75mm,掌侧成角为 3°,桡侧成角为 21°。功能结果极佳,平均 VAS 评分小于 1,DASH 评分为 12,Mayo 腕关节评分为 87。与锁定板相比,材料成本总体降低了 15300 欧元。

结论

我们的技术具有出色的生物力学稳定性,能够立即进行功能康复,具有良好的解剖学和功能结果,且成本显著降低。

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