| 掌侧钢板结合外支架治疗高能量损伤C3型桡骨远端骨折 |
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投稿时间：2009-03-09
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| 作者 | Author | 单位 | Address | E-Mail |
| 邓迎生 |
DENG Ying-sheng |
长海医院骨科,上海 200433 |
Department of Orthopaedics,the 1st Affiliated People's Hospital of Traffic University of Shanghai,Shanghai 200433,China |
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| 张秋林 |
ZHANG Qiu-lin |
长海医院骨科,上海 200433 |
Department of Orthopaedics,the 1st Affiliated People's Hospital of Traffic University of Shanghai,Shanghai 200433,China |
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| 王秋根 |
WANG Qiu-gen |
上海交通大学附属第一人民医院骨科 |
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wangqiugen@126.com |
| 纪方 |
JI Fang |
长海医院骨科,上海 200433 |
Department of Orthopaedics,the 1st Affiliated People's Hospital of Traffic University of Shanghai,Shanghai 200433,China |
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| 蔡晓冰 |
CAI Xiao-bing |
长海医院骨科,上海 200433 |
Department of Orthopaedics,the 1st Affiliated People's Hospital of Traffic University of Shanghai,Shanghai 200433,China |
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| 唐昊 |
TANG Hao |
长海医院骨科,上海 200433 |
Department of Orthopaedics,the 1st Affiliated People's Hospital of Traffic University of Shanghai,Shanghai 200433,China |
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| 吴剑宏 |
WU Jian-hong |
长海医院骨科,上海 200433 |
Department of Orthopaedics,the 1st Affiliated People's Hospital of Traffic University of Shanghai,Shanghai 200433,China |
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| 汪方 |
WANG Fang |
长海医院骨科,上海 200433 |
Department of Orthopaedics,the 1st Affiliated People's Hospital of Traffic University of Shanghai,Shanghai 200433,China |
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| 汤旭日 |
TANG Xu-ri |
长海医院骨科,上海 200433 |
Department of Orthopaedics,the 1st Affiliated People's Hospital of Traffic University of Shanghai,Shanghai 200433,China |
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| 谢杨 |
XIE Yang |
长海医院骨科,上海 200433 |
Department of Orthopaedics,the 1st Affiliated People's Hospital of Traffic University of Shanghai,Shanghai 200433,China |
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| 官正茂 |
GUAN Zheng-mao |
长海医院骨科,上海 200433 |
Department of Orthopaedics,the 1st Affiliated People's Hospital of Traffic University of Shanghai,Shanghai 200433,China |
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| 杨长伟 |
YANG Chang-wei |
长海医院骨科,上海 200433 |
Department of Orthopaedics,the 1st Affiliated People's Hospital of Traffic University of Shanghai,Shanghai 200433,China |
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| 王谦 |
WANG Qian |
长海医院骨科,上海 200433 |
Department of Orthopaedics,the 1st Affiliated People's Hospital of Traffic University of Shanghai,Shanghai 200433,China |
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| 期刊信息：《中国骨伤》2009年，第22卷，第7期，第543-546页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的：初步研究掌侧支撑钢板结合外支架等固定治疗高能量损伤C3型桡骨远端骨折的疗效。
方法：自2001年1月至2007年6月，使用掌侧入路支撑钢板、跨腕关节外支架并结合克氏针撬拨、植骨等技术治疗C3型桡骨远端骨折13例，男9例，女4例；年龄26～47岁，平均37岁。闭合性骨折9例，开放性骨折4例 (GustinoⅠ型3例，Ⅱ型1例).病程2 h～17 d.比较手术前后掌倾角、尺偏角、桡骨短缩及关节活动范围等，初步评价其临床疗效。
结果：随访7～29个月，平均18个月，患者掌倾角、尺偏角、桡骨短缩及关节面均获明显改善。桡骨远端影像学评估采用Stewart改良的Sarmiento评分，优9例，良4例；腕关节功能采用Gartland-Werley标准评定，优5例，良6例，可2例。
结论：①掌侧钢板可支撑掌侧皮质，防止骨折碎片向掌侧移位和维持掌倾角，还能为背桡侧外支架提供掌侧支点；②外支架可借助掌侧支点维持桡骨长度和掌倾角，并利于对损伤关节软骨的修复产生“模造”;③克氏针、植骨等技术的运用可进一步稳定骨折端。 |
| 【关键词】桡骨 关节内骨折 骨折固定术,内 固定装置,外 |
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| Combination of volar buttress plate with external fixator for the distal radial fractures of type C3 caused by high-energy injuries |
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ABSTRACT
Objective: To preliminarily explore the effect of combination of volar buttress plate with external fixator for the distal radial fractures of type C3 caused by high-energy injuries.
Methods: From January 2001 to June 2007,13 patients with distal radial fracture of type C3,9 males and 4 females aged from 26 to 47(average 37 years),were treated with volar buttress plate combined with external fixator plus the techniques of K-wires and bone grafting as necessary,whose effects were evaluated preliminarily through comparing the volar tilt,radial inclination,radial shortening and wrist function.
Results: Followed up from 7 to 29 months(average 18 months),the volar tilt,radial inclination,radial shortening and wrist function of all patients recovered remarkably. Nine patients achieved excellent and 4 good according to Sarmiento score(modified by Stewart) in the radiological manifestation,while 5 patients displayed excellent,6 good,and 2 fair according to Gartland-Werley functional assessment system.
Conclusion: ①Volar buttress plate could support the valor cortex in order to prevent comminuted fragment from displacing and maintain volar tilt and to provide the volar fulcrum for external fixator. ②External fixator,with the assistance of volar fulcrum,could maintain the volar tilt and the height of distal radius and help unload the fossa. ③Supplemental K-wires fixation and the bone graft may assist fracture stable. |
| KEY WORDS Radius Intraarticular fracture Fracture fixation,internal Fixation devices,external |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 邓迎生,张秋林,王秋根,纪方,蔡晓冰,唐昊,吴剑宏,汪方,汤旭日,谢杨,官正茂,杨长伟,王谦.掌侧钢板结合外支架治疗高能量损伤C3型桡骨远端骨折[J].中国骨伤,2009,22(7):543~546 |
| 英文格式: | DENG Ying-sheng,ZHANG Qiu-lin,WANG Qiu-gen,JI Fang,CAI Xiao-bing,TANG Hao,WU Jian-hong,WANG Fang,TANG Xu-ri,XIE Yang,GUAN Zheng-mao,YANG Chang-wei,WANG Qian.Combination of volar buttress plate with external fixator for the distal radial fractures of type C3 caused by high-energy injuries[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(7):543~546 |
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