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桡骨远端骨折:采用背侧双柱锁定钢板固定的微创钢板接骨术。

Distal radius fractures: Minimally invasive plate osteosynthesis with dorsal bicolumnar locking plates fixation.

作者信息

Chen Alvin Chao-Yu, Chou Ying-Chao, Cheng Chun-Ying

机构信息

Bone and Joint Research Center, Chang Gung Memorial Hospital-Linkou College of Medicine, Chang Gung University, Taiwan, Republic of China.

出版信息

Indian J Orthop. 2017 Jan-Feb;51(1):93-98. doi: 10.4103/0019-5413.197555.

Abstract

BACKGROUND

Controversy still exists regarding the current treatment modalities for unstable distal radius fractures. There are yet few articles investigating the efficacy of bicolumnar dorsal plating technique, which is designed to minimize tissue dissection while providing sufficiently secure fixation. A clinical study was performed to evaluate the feasibility of the minimally invasive plate osteosynthesis (MIPO) technique using a modified dorsal approach for the treatment of distal radius fractures.

MATERIALS AND METHODS

Thirty patients with unilateral distal radius fracture who underwent bicolumnar plate fixation with a minimally invasive dorsal approach between September 2008 and December 2010 were included in this retrospective study. Twenty four patients (8 men and 16 women) with a mean age of 53 years (range 18-85 years) were available for followup of at least 1 year or more were included in final study. Herein, we report the functional radiological outcomes of the study. There were three cases of AO Type A fracture, five cases of AO Type B fracture, and 16 cases of AO Type C fracture.

RESULTS

The union was achieved in all the patients. The functional results at one-year followup, assessed using the modified Gartland and Werley scoring system, were excellent in 14 patients, good in seven patients, and fair in three patients. The average correction of deformity was 4.1 mm for radial height, 7.6° for radial inclination, and 20.7° for volar tilt.

CONCLUSIONS

MIPO with a dorsal approach is a feasible option for the management of displaced distal radius fractures and can result in favorable surgical outcomes.

摘要

背景

目前对于不稳定型桡骨远端骨折的治疗方式仍存在争议。很少有文章研究双柱背侧钢板固定技术的疗效,该技术旨在减少组织剥离同时提供足够牢固的固定。进行了一项临床研究以评估采用改良背侧入路的微创钢板接骨术(MIPO)治疗桡骨远端骨折的可行性。

材料与方法

本回顾性研究纳入了2008年9月至2010年12月间采用微创背侧入路进行双柱钢板固定的30例单侧桡骨远端骨折患者。最终研究纳入了24例患者(8例男性和16例女性),平均年龄53岁(范围18 - 85岁),这些患者至少随访1年或更长时间。在此,我们报告该研究的功能影像学结果。其中AO A型骨折3例,AO B型骨折5例,AO C型骨折16例。

结果

所有患者均实现骨折愈合。采用改良的Gartland和Werley评分系统评估,1年随访时功能结果为优的患者14例,良的患者7例,可的患者3例。桡骨高度平均畸形矫正4.1mm,桡骨倾斜度平均矫正7.6°,掌倾角平均矫正20.7°。

结论

背侧入路的MIPO是治疗移位型桡骨远端骨折的一种可行选择,可取得良好的手术效果。

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