CAJ | 학술논문

目的：探讨掌侧入路T型锁定加压钢板内固定治疗桡骨远端合并干骺端及骨干粉碎性骨折的临床疗效。方法2007年5月～2012年5月，我院骨科采用掌侧入路 T型锁定加压钢板内固定治疗桡骨远端合并干骺端及骨干粉碎性骨折40例，其中男16例，女24例，平均年龄43.5±7.3岁（25～74岁）。根据AO分类标准：A3型10例，C2型14例，C3型16例，均采用经掌侧入路，骨缺损严重者置入人工骨。结果所有患者均获随访，平均25个月（12～45个月），骨折平均愈合时间16周（10～28周）。根据Gratland-Werley功能评估标准进行评定：优32例，良5例，中2例，差1例，优良率达92.5％。1例患者术后出现正中神经麻痹但3个月后均自愈，1例患者出现下尺桡关节炎，2例患者出现关节间隙轻度狭窄但无腕关节功能障碍，未见骨感染、骨分离、内固定松动等并发症。结论掌侧入路T型锁定加压钢板内固定治疗桡骨远端合并干骺端及骨干粉碎性骨折的临床疗效确切，它可提供较好的轴向和角度稳定性并具有整体固定特点，有利于术后早期有效的功能锻炼，降低术后并发症的发生。
목적：탐토장측입로T형쇄정가압강판내고정치료뇨골원단합병간후단급골간분쇄성골절적림상료효。방법2007년5월～2012년5월，아원골과채용장측입로 T형쇄정가압강판내고정치료뇨골원단합병간후단급골간분쇄성골절40례，기중남16례，녀24례，평균년령43.5±7.3세（25～74세）。근거AO분류표준：A3형10례，C2형14례，C3형16례，균채용경장측입로，골결손엄중자치입인공골。결과소유환자균획수방，평균25개월（12～45개월），골절평균유합시간16주（10～28주）。근거Gratland-Werley공능평고표준진행평정：우32례，량5례，중2례，차1례，우량솔체92.5％。1례환자술후출현정중신경마비단3개월후균자유，1례환자출현하척뇨관절염，2례환자출현관절간극경도협착단무완관절공능장애，미견골감염、골분리、내고정송동등병발증。결론장측입로T형쇄정가압강판내고정치료뇨골원단합병간후단급골간분쇄성골절적림상료효학절，타가제공교호적축향화각도은정성병구유정체고정특점，유리우술후조기유효적공능단련，강저술후병발증적발생。
Objective The purpose of this study was to assess the radiographic and functional outcomes of treatment with the T -locking compression plate (T-LCP) system for distal radius fractures with metaphyseal and diaphyseal extension .Methods This retrospective study was performed between May 2007 and June 2012 ,and 40 consecutive patients underwent surgical treatment for a comminuted distal radial fracture that extended from the distal part of the radius to involve the diaphysis proximally with application of a T-LCP .There were 16 males and 24 females , average age was 43.5 ± 7.3 years (range ,25~74 years) .Based with AO classification :10 cases of type A3 ,14 cases of type C2 ,and 16 cases of type C3. All the cases were treated with open reduction and T-LCP fixation through volar approach .Results All the patients were followed up . The average follow -up period was 25 months (range ,12~45 months) .The average time to fracture union was 16 weeks (range ,10~28 weeks) . According to the Gartland-Werley demerit-point system :32Results were rated as excellent ,5 as good ,2 as fair ,and 1 as bad .The overall sat-isfactory rate was 92.5% .One patient had paresthesia in median nerve distribution without motor deficit .This symptom resolved spontaneously after 3 months;one patient showed DRUJ arthritis ;2 wrists showed mild arthritic changes without restriction in daily activities ;no patients showed infections ,separation ,internal fixation loosening and other complications .Conclusion Based on our experience ,T-LCP is useful in the management of comminuted fractures of the distal radius ,in which there is proximal extension into the diaphysis and can avoid or minimize the complications of external fixation or dorsal bridging distraction plate .