Khatri Kavin, Sharma Vijay, Farooque Kamran, Tiwari Vivek
Department of Orthopaedics, GGS Medical College Faridkot, Baba Farid University of Health Sciences, Faridkot, India.
Department of Orthopaedics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, (AIIMS), New Delhi, Delhi, India.
Arch Trauma Res. 2016 May 9;5(2):e25174. doi: 10.5812/atr.25174. eCollection 2016 Jun.
Unstable distal end radius fractures are difficult to manage and so various treatment modalities have been described. The use of variable-angle locking plates is promoted for the management of these fractures.
This study aimed to evaluate the functional and radiological outcomes in unstable distal end radius fractures treated with variable-angle locking plates.
We reviewed 23 unstable distal end radius fractures that were treated at our institution with volar variable-angle locking plates. The mean age of the patients was 32.82 ± 11.81 years (range 19 to 62) and the mean duration of follow-up was 11.04 ± 2.47 months (range 6 to 15). All of the patients underwent open reduction and internal fixation with a variable-angle locking plate. Radiological parameters such as radial inclination, length, tilt, and ulnar variance were measured at six weeks and at the final follow-up. The functional evaluation was conducted by measuring the range of motion at the wrist joint as well as the grip strength. Gartland and Werley's demerit scoring system was used to assess the final outcome.
There were two cases of superficial infection that responded to oral antibiotics. One patient had developed a hypertrophic scar, while another had carpal tunnel syndrome that was conservatively managed. There was a significant improvement in the functional indices from six weeks to the final follow-up, while the radiological parameters were maintained. According to Gartland and Werley, excellent results were reported in 65.2% cases, while good results were present in 35% cases.
The use of variable-angle locking plates in treating unstable distal end radius fractures is associated with excellent to good functional outcomes with minimal complications.
桡骨远端不稳定骨折难以处理,因此已有多种治疗方式被描述。可变角度锁定钢板被推荐用于此类骨折的治疗。
本研究旨在评估采用可变角度锁定钢板治疗桡骨远端不稳定骨折的功能和影像学结果。
我们回顾了在我院采用掌侧可变角度锁定钢板治疗的23例桡骨远端不稳定骨折。患者的平均年龄为32.82±11.81岁(范围19至62岁),平均随访时间为11.04±2.47个月(范围6至15个月)。所有患者均接受了可变角度锁定钢板切开复位内固定术。在术后6周和最终随访时测量桡骨倾斜度、长度、成角和尺骨变异等影像学参数。通过测量腕关节活动范围以及握力进行功能评估。采用Gartland和Werley的缺点评分系统评估最终结果。
有2例浅表感染,经口服抗生素治疗后好转。1例患者出现增生性瘢痕,另1例患有腕管综合征,采用保守治疗。从6周随访至最终随访,功能指标有显著改善,而影像学参数保持稳定。根据Gartland和Werley的标准,65.2%的病例结果为优,35%的病例结果为良。
使用可变角度锁定钢板治疗桡骨远端不稳定骨折可获得优良的功能结果,并发症极少。