目的 探讨应用尺骨远端钩形锁定钢板(locking compression plate-distal ulna hook plate, LCP-DUHP)治疗尺骨远端不稳定骨折的临床效果。
方法 2013年1月-2014年7月,采用切开复位、LCP-DUHP内固定治疗13例尺骨远端不稳定骨折。男8例,女5例;年龄21~72岁,平均45岁。单纯尺骨远端骨折7例,均为直接暴力致伤,其中开放性损伤3例(GastiloⅡ型1例、Ⅲ型2例);桡骨远端合并尺骨远端骨折6例,均为摔伤。尺骨远端骨折均累及下尺桡关节水平,根据改良Q分型标准:Q2型7例,Q3型3例,Q4型2例,Q5型1例。受伤至内固定手术时间为3~14 d,平均7.69 d。
结果 术后患者切口均Ⅰ期愈合。12例患者获随访,随访时间12~24个月,平均19.7个月。X线片检查示,除1例开放性尺桡骨远端粉碎性骨折未达解剖复位标准外,其余患者骨折均达解剖复位。所有骨折均愈合,愈合时间为10~20周,平均12.6周。末次随访时,臂-肩-手功能障碍评分(DASH)为0~36分,平均10.33分。
结论 应用LCP-DUHP治疗尺骨远端不稳定骨折,可以提供稳定的固定效果,操作简便,但需注意其放置的安全范围。
Citation:
夏江, 马涛, 徐磊, 胡斌, 秦宏玖. 尺骨远端钩形锁定钢板治疗尺骨远端不稳定骨折. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(9): 1181-1183. doi: 10.7507/1002-1892.20160241
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Goikoetxea X, Garmilla I, Etxebarria I, et al. Isolated intra-articular fracture of the distal ulna:a rare injury related to airbag deployment. J Orthop Trauma, 2006, 20(4):292-294.
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Kang HJ, Shim DJ, Yong SW, et al. Operative treatment for isolated distal ulnar shaft fracture. Yonsei Med J, 2002, 43(5):631-616.
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Kim JK, Koh YD, Do NH. Should an ulnar styloid fracture be fixed following volar plate fixation of a distal radial fracture. J Bone Joint Surg (Am), 2010, 92(1):1-6.
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李书振, 陈跃平, 林宗汉, 等.尺骨茎突骨折对桡骨远端骨折后腕关节功能的影响.中国修复重建外科杂志, 2012, 26(6):666-670.
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董加纯, 尹望平, 陈延超, 等.尺骨茎突骨折固定与否对桡尺远侧关节旋转稳定性的影响.中华手外科杂志, 2015, 31(4):266-268.
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Lee SK, Kim KJ, Park JS, et al. Distal ulna hook plate fixation for unstable distal ulna fracture associated with distal radius fracture. Orthopedics, 2012, 35(9):e1358-1364.
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Hazel A, Nemeth N, Bindra R. Anatomic considerations for plating of the distal ulna. J Wrist Surg, 2015, 4(3):188-193.
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- 1. Goikoetxea X, Garmilla I, Etxebarria I, et al. Isolated intra-articular fracture of the distal ulna:a rare injury related to airbag deployment. J Orthop Trauma, 2006, 20(4):292-294.
- 2. Kang HJ, Shim DJ, Yong SW, et al. Operative treatment for isolated distal ulnar shaft fracture. Yonsei Med J, 2002, 43(5):631-616.
- 3. Kim JK, Koh YD, Do NH. Should an ulnar styloid fracture be fixed following volar plate fixation of a distal radial fracture. J Bone Joint Surg (Am), 2010, 92(1):1-6.
- 4. 李书振, 陈跃平, 林宗汉, 等.尺骨茎突骨折对桡骨远端骨折后腕关节功能的影响.中国修复重建外科杂志, 2012, 26(6):666-670.
- 5. 董加纯, 尹望平, 陈延超, 等.尺骨茎突骨折固定与否对桡尺远侧关节旋转稳定性的影响.中华手外科杂志, 2015, 31(4):266-268.
- 6. Lee SK, Kim KJ, Park JS, et al. Distal ulna hook plate fixation for unstable distal ulna fracture associated with distal radius fracture. Orthopedics, 2012, 35(9):e1358-1364.
- 7. Hazel A, Nemeth N, Bindra R. Anatomic considerations for plating of the distal ulna. J Wrist Surg, 2015, 4(3):188-193.