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锁定加压接骨板(LCP)治疗与桡骨远端骨折相关的不可复位或不稳定型尺骨远端骨折。

LCP distal ulna plate fixation of irreducible or unstable distal ulna fractures associated with distal radius fracture.

作者信息

Han Soo Hong, Hong In Tae, Kim Woo Hyun

机构信息

Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea,

出版信息

Eur J Orthop Surg Traumatol. 2014 Dec;24(8):1407-13. doi: 10.1007/s00590-014-1427-y. Epub 2014 Feb 25.

Abstract

PURPOSE

The advent of locking compression plate (LCP) has provided convenient and secure fixation of distal ulna fractures. This study was performed to evaluate the functional and clinical outcomes following LCP distal ulna plate fixation of irreducible or unstable distal ulna fractures with concomitant distal radius fractures.

METHODS

Retrospective review of 17 patients who had been treated with LCP distal ulna plates for distal ulna fractures was performed. The average age of the patients was 58.9 years (range 21-87 years), and the mean follow-up period was 15 months (range 12-20 months). This study consisted of eleven fractures involving metaphysis and six ulna styloid base fractures. Fracture union, radiologic parameters, stability of the distal radioulnar joint (DRUJ), and functional outcomes, including ROM, grip strength, and functional scores were evaluated.

RESULTS

All patients showed bony union, the average radial height was 10.5 mm, and the ulnar variance was 0.8 mm on final radiographs. None of the patients had instability of the DRUJ compared with the opposite wrist, and the subluxation ratio was within normal range on the follow-up CT scan. There were 6 excellent and 11 good cases according to Sarmiento's modified wrist score at the last follow-up.

CONCLUSIONS

Locking compression plate distal ulna plate fixation of irreducible or unstable distal ulna fractures after stabilization of concomitant distal radius fractures showed favorable results in union, alignment, and functional outcomes and therefore could be one of the recommendable implant options for distal ulna fractures.

摘要

目的

锁定加压钢板(LCP)的出现为尺骨远端骨折提供了方便且可靠的固定方法。本研究旨在评估使用LCP尺骨远端钢板固定不可复位或不稳定的尺骨远端骨折并伴有桡骨远端骨折后的功能和临床结果。

方法

对17例接受LCP尺骨远端钢板治疗尺骨远端骨折的患者进行回顾性研究。患者平均年龄58.9岁(范围21 - 87岁),平均随访时间15个月(范围12 - 20个月)。本研究包括11例涉及干骺端的骨折和6例尺骨茎突基底骨折。评估骨折愈合情况、影像学参数、下尺桡关节(DRUJ)稳定性以及功能结果,包括活动度、握力和功能评分。

结果

所有患者均实现骨愈合,最终X线片显示平均桡骨高度为10.5mm,尺骨变异为0.8mm。与对侧手腕相比,所有患者均无DRUJ不稳定,随访CT扫描时半脱位率在正常范围内。根据Sarmiento改良腕关节评分,末次随访时有6例优和11例良。

结论

在稳定伴有桡骨远端骨折后,使用锁定加压钢板进行尺骨远端钢板固定不可复位或不稳定的尺骨远端骨折,在骨折愈合、对线和功能结果方面显示出良好效果,因此可能是尺骨远端骨折推荐的植入物选择之一。

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