Department of Orthopedic Surgery, Wonkwang University Hospital, Iksan, South Korea.
Department of Orthopaedic Surgery, Chung-Ang University Hospital, Seoul, South Korea.
J Hand Surg Asian Pac Vol. 2022 Jun;27(3):517-523. doi: 10.1142/S2424835522500527. Epub 2022 May 27.
Few studies have reported the outcomes of primary volar locking plate fixation in Gustilo and Anderson type II and IIIA open distal radius fractures. We report the outcomes of treatment of Gustilo and Anderson type II and IIIA open distal radius fractures using primary volar locking plate fixation. We retrospectively reviewed 24 patients with open distal radius fractures who were treated using primary volar locking plate fixation. The range of motion (ROM) and modified Mayo wrist scores were measured to assess functional outcomes. Radiological outcomes included the bone union period, radial inclination, volar tilt, radial length and ulnar variance. Functional outcomes, including mean ROM in flexion (39.1°) and extension (52.5°), improved following primary volar locking plate treatment. Radiological outcomes were as follows. Mean bone union period, radial length and ulnar variance were 7.8 months, 10.4 and 0.7 mm, respectively. Two patients had superficial wound infection 2 weeks after surgery and one patient had non-union of the radius that required implant removal, autologous iliac crest bone graft and plate re-fixation. Primary volar locking plate fixation is a safe and reliable treatment option for Gustilo and Anderson type II and IIIA open distal radius fractures. By providing firm stabilisation and allowing early ROM exercise, primary volar locking plate fixation resulted in good functional and radiological outcomes. Level IV (Therapeutic).
很少有研究报道过原发性掌侧锁定板固定治疗 Gustilo 和 Anderson II 型和 IIIA 型开放性桡骨远端骨折的结果。我们报告了使用原发性掌侧锁定板固定治疗 Gustilo 和 Anderson II 型和 IIIA 型开放性桡骨远端骨折的结果。我们回顾性分析了 24 例采用原发性掌侧锁定板固定治疗的开放性桡骨远端骨折患者。测量了关节活动度（ROM）和改良 Mayo 腕关节评分，以评估功能结果。影像学结果包括骨愈合时间、桡骨倾斜度、掌倾角、桡骨长度和尺骨变异。原发性掌侧锁定板治疗后，平均 ROM 在屈曲（39.1°）和伸展（52.5°）方面得到改善。影像学结果如下。平均骨愈合时间、桡骨长度和尺骨变异分别为 7.8 个月、10.4 毫米和 0.7 毫米。2 例患者在术后 2 周出现浅表伤口感染，1 例患者出现桡骨不愈合，需要取出植入物、自体髂嵴骨移植和重新固定钢板。原发性掌侧锁定板固定是 Gustilo 和 Anderson II 型和 IIIA 型开放性桡骨远端骨折的一种安全可靠的治疗选择。通过提供牢固的稳定性并允许早期 ROM 锻炼，原发性掌侧锁定板固定可获得良好的功能和影像学结果。IV 级（治疗）。
