| Objective To compare the clinical effects of the variable angle two-column locking compression plate(LCP) combined with Kirschner wires and external fixator in the treatment of AO/ASIF tape-C distal radius fractures.To analyse the therapeutic strategies and provide guidance for clinical treatment of AO/ASIF tape-C fracture of the distal radius.Methods From January 2012 to January 2015,51 patients of AO/ASIF tape-C distal radius fracture were treated in traumatic centre,34 cases included in this study and with satisfied follow-up. variable angle two-column LCP combined with Kirschner wires group consisted of 20 cases. they were 12 women and 8 men, with the average age of 53.06 years(from 31 to 68 years).according to AO/ASIF classification,6cases were of C 1,1lcases of C2 and 3cases of C3; external fixator group consisted of 14 cases. they were 10 women and 4 men, with the average age of 52.20 years(from 28 to 70 years).according to AO/ASIF classification,4cases were of C1,4cases of C2 and 6 cases of C3.all were closed fracture. bone defects were treated with bone grafts. variable angle two-column LCP group with an average time of 3.92 days after injury, external fixator group with an average time of 3.96 days after injury,The early rehabilitation was carried out after the operation. measured the activity of the wrist(palmar flexion, dorsiflexion, ulnar deviation, radial deviation, pronation, supination), and their associated imaging date(volar tilt, unlar inclination, radial length, recovery of the articular surface) the function outcome of wrist joint were evaluated by Gartland-Werley scoring system, assessment of anatomical results modified from Sarmiento.Results All patients were followed up. variable angle two-column LCP group was followed up for an average of 23.01 months (from 12 to 36 months). All fractures united well after an average of 10.97 weeks, external fixator group was followed up for an average of 22.28 months (from 12 to 40 months). All fractures united well after an average of 11.48 weeks.to remove the Kirschner wires after an average of 6 weeks. According to the the Gartland-Werley score the excellent and good rate was 85.0% in variable angle two-column LCP group and 78.6% in the external fixator group, According to the modified Sarmiento score the excellent and good rate was 80.0% in variable angle two-column LCP group and 71.4% in the external fixator group. There were no significant differences in unlar inclination,radial height, the Gartland-Werley score,wrist unlar deviration,radial deviration,supination,pronation. The volar tilt, wrist flexion, wrist extension, recovery of the articular surface was better in the variable angle two-column LCP group than the external fixator group.There were 1 case of complex regional pain syndrome,1 case of rupture of tendon of extensor pollicis longus,1 case of fixator loosing in the variable angle two-column LCP group, Tendon irritation in 1 patient, fixator loosing in 1 patient, traumatic arthritis in one patient,2 cases of pin tract infection.Conclusions The variable angle two-column LCP group had better imaging outcomes and can get reduction well and maintain the reduction. But both of the groups can achieve satisfactory clinical results. The variable angle two-column LCP group allowed early functional rehabilitation, complications will be less, consequently leading good results to the function of wrist. It’s an effective method to treat AO/ASIF tape-C fracture of the distal radius.infact the choices of treatment method depends on patient’s clinical conditions. Bone grafts to correct bone defects intraoperative could assist in maintaining support effectively and promote the healing of fracture. |
PDF Full Text Request