CAJ | 학술논문

目的探讨π型钢板内固定加植骨术治疗中青年桡骨远端严重粉碎性骨折的效果.方法 2005年1月至2008年5月收治并获得随访的中青年桡骨远端严重粉碎性骨折21例,根据AO分型:A3型5例,C2型7例,C3型9例.术前掌倾角为-34°～21°,平均-15°;尺偏角-10°-21°,平均14.5°;桡尺骨相对长度-2.0～0.5 cm,平均-1.2 cm.均采用π型钢板内固定加自体髂骨移植术,术后平均石膏托外固定6周后行功能锻炼.术后摄X线片观察骨折愈合情况,测量术前、术后掌倾角、尺偏角及桡尺骨远端相对长度.结果术后随访9～18个月,平均13.5个月;骨折愈合时间3～8个月,平均6.2个月;术后掌倾角为8°～170°,平均13.2°;尺偏角为16°～29°,平均22.7°;桡尺骨相对长度为0.9～1.6 cm,平均1.3 cm.骨折愈合拆除内固定后:前臂旋前60°～87.,平均75.0°;旋后72°～97°,平均87.7°.术后腕关节功能采用Gartlant和Werley标准评分:优13例,良6例,可2例,优良率为90.5%,未出现肌腱断裂、感染、骨不连等并发症.结论 π型钢板内固定加自体骨移植术是治疗中青年桡骨远端粉碎性骨折的一种有效方法.
목적 탐토π형강판내고정가식골술치료중청년뇨골원단엄중분쇄성골절적효과.방법 2005년1월지2008년5월수치병획득수방적중청년뇨골원단엄중분쇄성골절21례,근거AO분형:A3형5례,C2형7례,C3형9례.술전장경각위-34°～21°,평균-15°;척편각-10°-21°,평균14.5°;뇨척골상대장도-2.0～0.5 cm,평균-1.2 cm.균채용π형강판내고정가자체가골이식술,술후평균석고탁외고정6주후행공능단련.술후섭X선편관찰골절유합정황,측량술전、술후장경각、척편각급뇨척골원단상대장도.결과 술후수방9～18개월,평균13.5개월;골절유합시간3～8개월,평균6.2개월;술후장경각위8°～170°,평균13.2°;척편각위16°～29°,평균22.7°;뇨척골상대장도위0.9～1.6 cm,평균1.3 cm.골절유합탁제내고정후:전비선전60°～87.,평균75.0°;선후72°～97°,평균87.7°.술후완관절공능채용Gartlant화Werley표준평분:우13례,량6례,가2례,우량솔위90.5%,미출현기건단렬、감염、골불련등병발증.결론 π형강판내고정가자체골이식술시치료중청년뇨골원단분쇄성골절적일충유효방법.
Objective To investigate the clinical efficacy of π-shaped plate combined with iliac autograft used in the treatment of comminuted distal radius fractures in the middle-aged. Methods Betwcen January 2005 and May 2008,21 cases of comminuted distal radius fractures in the middle-aged were treated with π-shaped plate combined with autograft.According to the AO/ASIF classification,there were 5cases of type A3,7 cases of type C2,and 9 cases of type C3.After operation their wrist joints were fixed at functional position with plaster brace and cast for an average of 6 weeks.The range of active motion of the wrist,the pre- and postoperative radiographic parameters,bone union,wound and the functional recovery of the wrist were observed and compared. Functional exercise was encouraged 6.2 months after fixation.Results All the patients were foHowed up for an average of 13.5 months.The average bone union time was 6 months.The average palmar tilt Was improved from preoperative-15° to postoperative 13.2°,the average ulnar variance was improved from preoperative 14.5° to postoperative 22.7°,and the average radioulnar relative length Was improved from preoperative -1.2 cm to postoperative 1.3 cm.No nonunion,screw loosening,broken plate,tendon rupture,or infection of the wounds was found in this series.The excellent to good rate Was 90.5% according to the rating SCale of Gartlant and Werely. Conclusion π-shaped plate combined with iliac autograft is a satisfactory technique for the treatment of comminuted distal radius fractures in the middle-aged.