Giordano Vincenzo, Pires Robinson Esteves Santos, Pesántez Rodrigo, Kojima Kodi, Koch Hilton A
Serviço de Ortopedia e Traumatologia Prof. Nova Monteiro, Hospital Municipal Miguel Couto, Rio de Janeiro, Brazil.
Clínica São Vicente, Rio de Janeiro, Brazil.
J Orthop Case Rep. 2018 May-Jun;8(3):42-46. doi: 10.13107/jocr.2250-0685.1100.
The use of mini plates as a reduction tool is an elegant technique for temporary stabilization of multifragmentary fractures. For some complex periarticular fractures with severe comminution close to the articular surface, mini plates seem to be a better option than K-wires for provisional as well as definitive fixation, because of the presence of small fragments and proximity to the joint increases the risk of additional fragmentation and articular penetration, respectively.
Five cases of complex periarticular fractures of the upper limb are presented. We used 2.3 mm mini plates as reduction plates for different situations, including one scapula fracture, one clavicle fracture, one distal humerus fracture, one proximal ulna fracture, and one distal radius fracture. In all cases, an excellent clinical outcome with a full return to pain-free activity was achieved after a minimum follow-up of 12 months.
We feel that these mini extra-articular implants are particularly helpful as temporary reduction tools before the application of the definitive implant to a reduced and stabilized the fracture. Because they have longer screws allowing better cortical purchase and low-profile allowing plate overlap, the procedure seems to be faster and easier when compared to the use of temporary K-wires and clamps.
使用微型钢板作为复位工具是一种用于临时稳定多段骨折的巧妙技术。对于一些靠近关节面且严重粉碎的复杂关节周围骨折,由于存在小碎片以及靠近关节分别增加了额外碎裂和关节穿透的风险,微型钢板在临时和确定性固定方面似乎比克氏针是更好的选择。
介绍了5例上肢复杂关节周围骨折的病例。我们针对不同情况使用2.3毫米微型钢板作为复位钢板,包括1例肩胛骨骨折、1例锁骨骨折、1例肱骨远端骨折、1例尺骨近端骨折和1例桡骨远端骨折。在所有病例中,经过至少12个月的随访,均获得了良好的临床结果,患者完全恢复至无痛活动状态。
我们认为,这些微型关节外植入物在应用确定性植入物之前作为临时复位工具特别有用,可使骨折复位并稳定。由于它们具有更长的螺钉以实现更好的皮质固定以及低轮廓以允许钢板重叠,与使用临时克氏针和夹子相比,该操作似乎更快且更容易。