杨帅智 陈禄 杨俊贵 黄昱 罗人彰

【摘要】 目的：探討T-LCP内固定治疗桡骨远端骨折患者的效果及对掌倾角、桡腕关节平衡度的影响。方法：选取2018年1月-2019年12月在本院接受桡骨远端骨折治疗的48例患者为研究对象，随机分为研究组与对照组，每组24例。研究组采用T-LCP内固定治疗，对照组则采用普通钢板内固定。比较两组的治疗效果、手术前后影像学检测指标以及术后3个月的腕关节评分。结果：研究组优良率高于对照组，差异有统计学意义（P<0.05）。术后，研究组掌倾角及桡腕关节平衡度均低于对照组，而尺偏角大于对照组（P<0.05）;手术前后，两组的桡骨高度比较，差异无统计学意义（P>0.05）。研究组术后各项腕关节评分均高于对照组，差异均有统计学意义（P<0.05）。结论：对桡骨远端骨折患者采用T-LCP内固定治疗具有较好的效果，患者掌倾角及桡腕关节平衡度均得到显著改善，有助于腕关节功能恢复，临床应用价值较高。

【关键词】 T-LCP内固定 桡骨远端骨折 掌倾角 桡腕关节平衡度

The Effect of T-LCP Internal Fixation in the Treatment of Distal Radius Fracture and Its Influence on Palmar Inclination， Balance of Radiocarpal Joint/YANG Shuaizhi， CHEN Lu， YANG Jungui， HUANG Yu， LUO Renzhang. //Medical Innovation of China， 2021， 18（05）： 0-035

[Abstract] Objective： To investigate the effect of T-LCP internal fixation in the treatment of distal radius fracture and its influence on palmar inclination and balance of radiocarpal joint. Method： A total of 48 patients who received treatment for distal radial fractures in our hospital from January 2018 to December 2019 were selected as subjects. They were randomly divided into study group and control group， 24 cases in each group. T-LCP internal fixation was used in the study group， while conventional plate internal fixation was used in the control group. The therapeutic effect， imaging indexes before and after surgery and wrist joint score 3 months after surgery were compared between the two groups. Result： The excellent rate in the study group was higher than that in the control group， the difference was statistically significant （P<0.05）. After surgery， the palmar inclination and radiocarpal balance degree in the study group were lower than those in the control group， while the ulnar deviation Angle was higher than that in the control group （P<0.05）. Before and after surgery， there were no significant differences in radius height between the two groups （P>0.05）. The postoperative wrist scores of the study group were higher than those of the control group， with statistical significance （P<0.05）. Conclusion： T-LCP internal fixation has a good effect on patients with distal radius fracture. The metacarpal inclination and radiocarpal joint balance of patients have been significantly improved， which is conducive to the recovery of wrist function and has high clinical application value.

[Key words] T-LCP internal fixation Distal radius fracture Palmar inclination Balance of radiocarpal joint

First-authors address： Foshan Fifth Peoples Hospital， Foshan 528211， China

doi：10.3969/j.issn.1674-4985.2021.05.009

桡骨远端骨折主要是指与桡骨远端关节面相距≤2 cm的骨折情况，大多由于间接暴力而导致，在急诊骨折患者中的发生率相对较高[1]。腕部肿胀、手腕活动受限以及明显压痛等是桡骨远端骨折的主要临床表现，对该疾病患者的治疗则主要以降低组织损伤，促进关节面平滑完整的有效恢复、解剖复位以及减低其腕部损伤功能为主[2]。临床中大多采用手法复位以及石膏对该类患者进行治疗，但对于存在粉碎性骨折患者则需要借助螺丝钉、克氏针或者T形钢板内固定等进行复位[3-4]。近年来，随着生物力学以及腕关节解剖研究的不断深入，大多数学者认为采用切开复位T型锁定加压钢板（T-LCP）内固定术对桡骨远端骨折患者进行治疗，能够取得较好效果，改善患者预后，但相关报道较少。本研究通过对桡骨远端骨折患者采用T-LCP内固定治疗，从而探讨对患者治疗效果的影响，现报道如下。……