Sun Kai, Sun Yufu
Department of Orthopaedics Surgery, Tianjin First Center Hospital, China.
Department of Orthopaedics Surgery, Tianjin First Center Hospital, China.
Int J Surg Case Rep. 2023 Oct 16;112:108943. doi: 10.1016/j.ijscr.2023.108943.
Open ulnar and radial shaft fractures refers to the simultaneous rupture and injury of the skin and subcutaneous soft tissue at the fracture, and is easy to cause wound infection, local soft tissue necrosis or osteomyelitis. The purpose of this paper is to observe the efficacy of external locking compression plate in the treatment of open fractures, so as to provide reference for clinical practice.
From January 2019 to January 2020, 11 patients with open ulnar or radial shaft fractures underwent surgery by a single surgeon. Physical examination, radiography, and functional scores were performed before surgery and the average follow-up was 14 months (range, 12 to16 months) after surgery. Clinical outcome scores were recorded. Six patients obtained excellent Anderson Scores, four of satisfactory and one of Unsatisfactory. No surgical complications, reoperations, nonunion and implant breakage in this series and the fractures can be healed from 6 to 12 months after the operation. All implant removal was requested for all cases.
Open ulnar and radial shaft fractures refers to the simultaneous rupture and injury of the skin and subcutaneous soft tissue at the fracture, which can connect the fracture site with the outside environment, and is easy to cause wound infection, local soft tissue necrosis or osteomyelitis. The open fracture mostly involves adjacent joints. If it is not treated in time, it is easy to lead to complications such as infection and nonunion. The locking plate is named as "internal fixation", which means the internal fixation is placed in the soft tissue, and is similar to the external fixator. However, its biomechanical properties still need to be verified, the appropriate screw position and number need to be further defined, and there is a lack of clinical validation of large number of cases.
In this study, locking compression plate externaI fixation for technology for the treatment of open ulnar and radial shaft fractures has the advantages of minimal trauma, simple operation, reliable fixation, fewer postoperative complications, and restored stability and function of forearm joints.
Level IV, therapeutic case series.
尺桡骨干开放性骨折是指骨折处皮肤及皮下软组织同时破裂损伤，易引发伤口感染、局部软组织坏死或骨髓炎。本文旨在观察外固定锁定加压钢板治疗开放性骨折的疗效，为临床实践提供参考。
2019年1月至2020年1月，11例尺桡骨干开放性骨折患者由同一位外科医生进行手术。术前进行体格检查、影像学检查及功能评分，术后平均随访14个月（范围12至16个月）。记录临床结果评分。6例患者获得优秀的安德森评分，4例为满意，1例不满意。本系列中无手术并发症、再次手术、骨不连及内固定断裂情况，骨折术后6至12个月可愈合。所有病例均要求取出内固定。
尺桡骨干开放性骨折是指骨折处皮肤及皮下软组织同时破裂损伤，可使骨折部位与外界环境相通，易引发伤口感染、局部软组织坏死或骨髓炎。开放性骨折多累及相邻关节，若不及时治疗，易导致感染和骨不连等并发症。锁定钢板虽名为“内固定”，但其内固定置于软组织中，与外固定架类似。然而，其生物力学性能仍需验证，合适的螺钉位置和数量需进一步明确，且缺乏大量病例的临床验证。
本研究中，锁定加压钢板外固定技术治疗尺桡骨干开放性骨折具有创伤小、操作简单、固定可靠、术后并发症少、恢复前臂关节稳定性及功能等优点。
四级，治疗性病例系列。
