[1]刘守正,江红艳,戴晨,等.掌侧锁定钢板内固定联合术中超声引导闭合复位尺背侧骨块的疗效分析[J].中国中医骨伤科杂志,2023,31(08):59-63.[doi:10.20085/j.cnki.issn1005-0205.230812 ]
　LIU Shouzheng,JIANG Hongyan,DAI Chen,et al.The Analysis of Efficacy of the Volar Locking Plate Internal Fixation Combined with Intraoperative Ultrasound Guidance on the Treatment of Closed Reduction of the Dorsal Ulnar Fragment[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(08):59-63.[doi:10.20085/j.cnki.issn1005-0205.230812 ]
点击复制

掌侧锁定钢板内固定联合术中超声引导闭合复位尺背侧骨块的疗效分析()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年08期
页码:
59-63
栏目:
临床报道
出版日期:
2023-08-15

文章信息/Info

Title:
The Analysis of Efficacy of the Volar Locking Plate Internal Fixation Combined with Intraoperative Ultrasound Guidance on the Treatment of Closed Reduction of the Dorsal Ulnar Fragment
文章编号:
1005-0205(2023)08-0059-05
作者:
刘守正1; 江红艳2; 戴晨1; 吴波亮1; 李业成3△
1杭州市余杭区第一人民医院骨科(杭州,311199)
2杭州未来科技城医院
3上海健康医学院附属崇明医院骨科
Author(s):
LIU Shouzheng1; JIANG Hongyan2; DAI Chen1; WU Boliang1; LI Yecheng3△
1 Department of Orthopedics,The First People's Hospital of Yuhang District,Hangzhou 311199,China; 2Hangzhou Future S&T City Hospital,Hangzhou 311121,China; 3Department of Orthopedics,Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences,Shanghai 202150,China.
关键词:
桡骨远端骨折;  骨折内固定术;  超声;  掌侧
Keywords:
distal radius fracture;  internal fracture fixation;  ultrasound;  volar
分类号:
R683.41
DOI:
10.20085/j.cnki.issn1005-0205.230812
文献标志码:
B
摘要:
目的:探讨掌侧锁定钢板内固定联合术中超声引导闭合复位尺背侧骨块的临床疗效。方法:回顾性分析2020年9月至2021年12月采用掌侧锁定钢板内固定联合术中超声引导闭合复位尺背侧骨块治疗的41例桡骨远端粉碎性骨折患者病例资料,市记录术前、术后1 d、术后1个月、术后3个月、术后6个月及末次随访时的掌倾角、尺偏角及桡骨高度,腕关节活动度,手术并发症,采用Gartland-Werley评分标准评价临床疗效。结果:41例患者均获完整随访,随访时间为10～12个月,平均为11个月。与术前相比术后各随访时间点掌倾角、尺偏角、桡骨高度及腕关节活动度均得到明显恢复,差异有统计学意义(P<0.05)。末次随访时根据Gartland-Werley腕关节评分标准:优38例,良2例,可1例,优良率为97.6%。末次随访时,X线检查无内固定物松动断裂及肌腱损伤等并发症发生。结论:采用超声引导闭合复位尺背侧骨块掌侧钢板内固定治疗桡骨粉碎性远端骨折可避免肌腱损伤,取得了良好临床效果。
Abstract:
Objective:To investigate the efficacy of the volar locking plate internal fixation combined with intraoperative ultrasound guidance on the treatment of closed reduction of the dorsal ulnar fragment.Methods:A retrospective analysis was conducted for 41 patients with comminuted distal radius fractures were treated with volar locking plate internal fixation combined with intraoperative ultrasound-guided closed reduction of dorsal ulnar bone block,from September 2020 to December 2021.The palmar inclination angle,ulnar deviation angle,radial height,wrist range of motion,and surgical complications were recorded before operation,1 d,1 month,3 months,6 months after operation,and at the last follow-up.The Gartland-Werley score was used to evaluate the clinical efficacy.Results:All the 41 patients were followed up completely.The follow-up time was 10-12 months,with an average of 11 months.The palmar inclination angle,ulnar deviation angle,radial height,and wrist range of motion were significantly improved at each follow-up time point compared with those before operation(P<0.05).At the last follow-up,according to Gartland-Werley wrist score criteria: the results were excellent in 38 cases,good in 2 cases,and fair in 1 case,with an excellent and good rate of 97.6%.At last follow-up,X-ray examination showed that there was no complication such as loosening of internal fixation or tendon injury.Conclusion:Ultrasound-guided closed reduction and volar plate fixation of dorsal ulnar fragment on the treatment of comminuted distal radius fractures can avoid tendon injury and achieve good clinical results.

参考文献/References:

[1] DY C J,WOLFE S W,JUPITER J B,et al.Distal radius fractures:strategic alternatives to volar plate fixation[J].Instr Course Lect,2014,63:27-37.
[2] 袁毅,罗兵,杨然,等.腕桡侧入路掌侧锁定钢板内固定治疗桡骨远端骨折25例[J].中国中医骨伤科杂志,2019,27(2):64-67.
[3] 朱恒杰,曾允富,程少文,等.低能量损伤老年患者中尺骨茎突骨折与桡骨远端骨折移位程度及骨密度的关系分析[J].中国中医骨伤科杂志,2023,31(3):26-30.
[4] 季佳庆,樊健,王健,等.掌侧锁定钢板治疗伴背侧骨块的桡骨远端骨折[J].实用骨科杂志,2021,27(8):678-683.
[5] 吴世桐,宁仁德,方闰,等.掌侧入路内固定治疗桡骨远端粉碎性骨折合并尺背侧骨折块的临床研究[J].创伤外科杂志,2021,23(5):338-341.
[6] PIDGEON T S,CRISCO J J,WARYASZ G R,et al.Ulnar styloid base fractures cause distal radioulnar joint instability in a cadaveric model[J].Hand(N Y),2018,13(1):65-73.
[7] LANS J,ALVAREZ J,KACHOOEI A R,et al.Dorsal lunate facet fracture reduction using a bone reduction forceps[J].J Wrist Surg,2019,8(2):118-123.
[8] ORBAY J L,FERNANDEZ D L.Volar fixation for dorsally displaced fractures of the distal radius:a preliminary report[J].J Hand Surg Am,2002,27(2):205-215.
[9] 周志,刘建,张挺,等.超声引导下闭合复位微创掌侧锁定钢板内固定治疗桡骨远端骨折[J].中医正骨,2019,31(7):48-51.
[10] WILLIAMS D,SINGH J,HEIDARI N,et al.Assessment of penetration of dorsal screws after fixation of the distal radius using ultrasound:cadaveric study[J].Ann R Coll Surg Engl,2016,98(1):138-142.
[11] 金少枫,苏坤阳,陈毕能,等.超声引导下经皮松解术治疗老年桡骨远端骨折非手术治疗后腕部指屈肌腱粘连[J].中医正骨,2022,34(8):12-19.

备注/Memo

备注/Memo:
基金项目:杭州市农业与社会发展科研引导项目(20220919Y099)
△通信作者 E-mail:312621691@qq.com
更新日期/Last Update: 2023-08-01