Vroemen Joy C, Dobbe Johannes G G, Sierevelt Inger N, Strackee Simon D, Streekstra Geert J
Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, University of Amsterdam, The Netherlands.
Orthopedics. 2013 Apr;36(4):e457-62. doi: 10.3928/01477447-20130327-22.
Over the past decade, several anatomical plates have been introduced to improve the result of open reduction and internal fixation of the distal radius. Using 3-dimensional imaging techniques, the authors studied the accuracy and reproducibility of distal radius positioning using anatomical plates.Distal radius fractures and the correction of these fractures were simulated with plastic bone models of radii. The authors simulated a defect by removing an arbitrary wedge shape from the artificial radii. Two surgeons corrected these fractures by placing 2 anatomical plate types according to the plate manufacturers' instructions. The residual positioning errors of the distal segment in relation to the unaffected radii were determined using 3-dimensional imaging and were compared with naturally occurring bilateral radius differences in healthy individuals. In many cases, positioning does not agree with differences based on bilateral asymmetry in healthy patients.This study indicated the accuracy of anatomical plates. Positioning an anatomical plate may lead to considerable residual errors in individual patients. Volar distal radius plate shapes differ among plate manufacturers. Therefore, one plate may perform better than another in an individual.
在过去十年中，已经推出了几种解剖钢板，以改善桡骨远端切开复位内固定的效果。作者使用三维成像技术，研究了使用解剖钢板进行桡骨远端定位的准确性和可重复性。使用桡骨的塑料骨模型模拟桡骨远端骨折及其复位。作者通过从人工桡骨中去除任意楔形来模拟缺损。两名外科医生根据钢板制造商的说明放置两种解剖钢板类型来矫正这些骨折。使用三维成像确定远端节段相对于未受影响桡骨的残余定位误差，并与健康个体中自然存在的双侧桡骨差异进行比较。在许多情况下，定位与健康患者基于双侧不对称的差异不一致。这项研究表明了解剖钢板的准确性。在个体患者中放置解剖钢板可能会导致相当大的残余误差。不同钢板制造商的掌侧桡骨远端钢板形状不同。因此，一种钢板在个体中可能比另一种表现更好。
