CAJ | 학술논문

目的探讨桡背侧双锁定钢板治疗桡骨远端骨折的临床疗效。方法 2007年3月至2009年12月采用桡背侧双锁定钢板治疗22例桡骨远端不稳定骨折患者，男12例，女10例；平均年龄47.5岁(21 ～ 78岁)。骨折AO分型：A3型1例；B2型5例；C1型2例，C2型11例，C3型3例。其中5例术中采用自体髂骨植骨。术后评估包括影像学测量尺偏角、掌倾角及桡骨高度，关节活动范围，握力测量，肩臂手功能丧失量表( DASH)评分，以及Gartland-Werley量表评分。结果 22例患者术后获平均19个月（12～32个月）随访。所钉患者骨折均在术后6个月内（2～6个月）获愈合。影像学测量尺偏角平均为25.3°(22°～29°)，掌倾角平均为12.1 °(8°～14°)，桡骨高度平均为1.1 cm(0.8 ～ 1.3 cm)。Stewart改良评分的优良率为90.9％。关节活动范围：背伸平均为53°(30°～68°)，掌屈平均为47°(32°～65°)，尺偏平均为22°(16°～ 30°)，桡偏平均为14°(11°～ 32°)，旋前平均为76°(30°～ 90°)，旋后平均为72°(10°～ 90°)。以健侧为参考，术侧握力平均为72％ (15 kg)。DASH评分平均为11.4分（0～70分），Gartland-Werley量表评分平均为3.4分（1～16分）。结论桡背侧双锁定钢板治疗桡骨远端不稳定骨折临床疗效较好，尤其是对于背侧皮质粉碎严重的患者，能够为骨折提供更加牢固的支撑。
목적 탐토뇨배측쌍쇄정강판치료뇨골원단골절적림상료효。방법 2007년3월지2009년12월채용뇨배측쌍쇄정강판치료22례뇨골원단불은정골절환자，남12례，녀10례；평균년령47.5세(21 ～ 78세)。골절AO분형：A3형1례；B2형5례；C1형2례，C2형11례，C3형3례。기중5례술중채용자체가골식골。술후평고포괄영상학측량척편각、장경각급뇨골고도，관절활동범위，악력측량，견비수공능상실량표( DASH)평분，이급Gartland-Werley량표평분。결과 22례환자술후획평균19개월（12～32개월）수방。소정환자골절균재술후6개월내（2～6개월）획유합。영상학측량척편각평균위25.3°(22°～29°)，장경각평균위12.1 °(8°～14°)，뇨골고도평균위1.1 cm(0.8 ～ 1.3 cm)。Stewart개량평분적우량솔위90.9％。관절활동범위：배신평균위53°(30°～68°)，장굴평균위47°(32°～65°)，척편평균위22°(16°～ 30°)，뇨편평균위14°(11°～ 32°)，선전평균위76°(30°～ 90°)，선후평균위72°(10°～ 90°)。이건측위삼고，술측악력평균위72％ (15 kg)。DASH평분평균위11.4분（0～70분），Gartland-Werley량표평분평균위3.4분（1～16분）。결론 뇨배측쌍쇄정강판치료뇨골원단불은정골절림상료효교호，우기시대우배측피질분쇄엄중적환자，능구위골절제공경가뢰고적지탱。
Objective To evaluate clinical results of double dorsal locking plates used in the fixation of distal radial fractures.MethodsFrom March 2007 to December 2009, 22 patients with distal radial fractures were fixed with double dorsal anatomical locking plates. They were 12 males and 10 females, with a mean age of 47. 5 years (21 to 78 years). By AO classification, there were one case of type A3, 5 cases of type B2, 2 cases of type C1, 11 cases of type C2 and 3 cases of type C3. Iliac autograft was performed in 5 patients. Clinical results and postoperative functional recovery were assessed by range of motion, grip strength, radiographic measurements of ulnar inclination, palmar tilt and radial height, the DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire and the Gartland-Werley sere.Results The mean follow-up was 19 months (12 to 32 months). All fractures united within 6 months (2 to 6 months). The mean ulnar inclination angle was 25.3° (22° to 29°), the mean palmar tilt angle was 12.1° (8° to 14°), and the mean radial height was 1.1 cm (0.8 to 1.3 cm). The mean radiographic Stewart score was excellent or fine in 90. 9％ of the patients. The mean dorsal extension was 53° (30° to 68°), the mean palmer flexion was 47° (32° to 65°), the mean ulnar inclination was 22° (16° to 30°), the mean radial inclination was 14° (11° to 32°), the mean pronation was 76° (30° to 90°) and the mean supination was 72° (10° to 90°). The mean grip strength of the operated side was 72％ (15 kg) of the normal side. The mean Q-DASH and Gartland-Werley scores were 11.4 (0 to 70) and 3.4 ( 1 to 16), respectively.Conclusions Fixation with double dorsal locking plates for unstable distal radial fractures can result in fine clinical results, especially for those with comminuted dorsal hone cortex.