Han L R, Jin C X, Yan J, Han S Z, He X B, Yang X F
Department of Orthopaedics, Liaocheng People's Hospital, Liaocheng, China.
Department of Orthopaedics, Liaocheng People's Hospital, Liaocheng, China
Genet Mol Res. 2015 Mar 31;14(1):2912-9. doi: 10.4238/2015.March.31.22.
This study compared the efficacy between external fixator combined with palmar T-plate internal fixation and simple plate internal fixation for the treatment of comminuted distal radius fractures. A total of 61 patients classified as type C according to the AO/ASIF classification underwent surgery for comminuted distal radius fractures. There were 54 and 7 cases of closed and open fractures, respectively. Moreover, 19 patients received an external fixator combined with T-plate internal fixation, and 42 received simple plate internal fixation. All patients were treated successfully during 12-month postoperative follow-up. The follow-up results show that the palmar flexion and dorsiflexion of the wrist, radial height, and palmar angle were significantly better in those treated with the external fixator combined with T-plate compared to those treated with the simple plate only (P < 0.05); however, there were no significant differences in radial-ulnar deviation, wrist range of motion, or wrist function score between groups (P > 0.05). Hence, the effectiveness of external fixator combined with T-plate internal fixation for the treatment of comminuted distal radius fractures was satisfactory. Patients sufficiently recovered wrist, forearm, and hand function. In conclusion, compared to the simple T-plate, the external fixator combined with T-plate internal fixation can reduce the possibility of the postoperative re-shifting of broken bones and keep the distraction of fractures to maintain radial height and prevent radial shortening.
本研究比较了外固定架结合掌侧T形钢板内固定与单纯钢板内固定治疗桡骨远端粉碎性骨折的疗效。根据AO/ASIF分类，共有61例C型桡骨远端粉碎性骨折患者接受了手术治疗。其中闭合性骨折54例，开放性骨折7例。此外，19例患者接受了外固定架结合T形钢板内固定，42例接受了单纯钢板内固定。所有患者术后12个月随访均获成功。随访结果显示，与单纯使用钢板治疗的患者相比，采用外固定架结合T形钢板治疗的患者手腕的掌屈和背伸、桡骨高度及掌倾角均明显更好（P < 0.05）；然而，两组之间的桡尺偏斜、腕关节活动范围或腕关节功能评分无显著差异（P > 0.05）。因此，外固定架结合T形钢板内固定治疗桡骨远端粉碎性骨折的效果令人满意。患者的腕关节、前臂和手部功能得到充分恢复。总之，与单纯T形钢板相比，外固定架结合T形钢板内固定可降低术后骨折再移位的可能性，并保持骨折端撑开以维持桡骨高度，防止桡骨短缩。
