Acu-Loc®2 volar distal radius bone plate system for repairing type C fracture of distal radius

doi:10.3969/j.issn.2095-4344.2017.07.008

Abstract

Abstract:

BACKGROUND: Distal radius C fractures belong to multiple fractures in the joint. Its treatment should recover various angles and joint surface continuity outside the joint. The recovery of palmar tilt angle, radial inclination angle and radial height is also very important for treating distal radius.

OBJECTIVE: To study the changes in palmar tilt angle, radial inclination angle and radial height after type C fractures of the distal radius repaired with Acu-Loc^®2 VDR bone plate system.

METHODS: From May 2015 to March 2016, 11 cases of type C distal radial fractures were treated with Acu-Loc^®2 VDR bone plate system. Preoperatively, the palmar tilt angle was -31° to -4° (-12.45° on average), and the radial inclination angle was 6° to 18° (11.18° on average), and the radial height was 1.92 mm to 8.68 mm (5.28 mm on average). X-ray films were observed at postoperative 4, 8 and 12 weeks and half a year in all patients. Palmar tilt angle, radial inclination angle and radial height were measured and observed using anteroposterior and lateral X-ray films during final follow-up. Wrist function was assessed with Gartland-Werley score.

RESULTS AND CONCLUSION: (1) 11 patients were followed and the postoperative follow-up ranged from 7 months to 15 months. X-ray films showed that the union of fractures was achieved in 6-8 weeks (6.5 weeks on average). No infection or internal fixation failure occurred. The articular facets were smooth in 10 patients and a little poor was found in 1 case (< 2 mm). (2) After operation, the palmar tilt angle was 8° to 15° (11.55° on average) (P < 0.05); the radial inclination angle was 22° to 27° (23.18° on average) (P < 0.05); the radial height was 8.01 mm to 13 mm (11.03 mm on average) (P < 0.05). (3) The results were excellent in 8 cases, good in 2 cases, and poor in 1 cases according to Gartland-Werley wrist function assessment; the excellent and good rate was 91%. (4) Acu-Loc^®2 VDR bone plate fixation can provide reliable fixation and effective support for type C distal radius fractures, which can recover the palmar tilt angle, the radial inclination angle and the radial height, so the Acu-Loc^®2 VDR bone plate is an ideal method to treat type C fractures of the distal radius.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Radius Fractures, Internal Fixators, Follow-Up Studies, Tissue Engineering

CLC Number:

R318

Chen Qun-qun, Qiao Rong-qin, Duan Rui-qi, Hu Nian-hong, Li Zhao, Shao Min. Acu-Loc^®2 volar distal radius bone plate system for repairing type C fracture of distal radius [J]. Chinese Journal of Tissue Engineering Research, 2017, 21(7): 1025-1030.

Figures/Tables 1

2.1 参与者数量分析按意向性处理，纳入11例患者，男1例，女10例。随访病例无丢失及脱落。试验流程图见图2。 2.2 随访结果 11例患者均获得随访，随访时间7-15个月，X射线片示所有骨折均骨性愈合，愈合时间6-8周，平均6.5周，没有发生感染及内固定失效。术后1例患者腕关节活动时疼痛，服用消炎止痛药物可缓解，6个月后症状基本消失。术后X射线检查提示10例关节面平整，1例稍差(<2 mm)。最近一次随访检查提示术后掌倾角8°-15°，平均11.55°，与术前比较差异有显著性意义(P < 0.05)；尺偏角22°-27°，平均23.18°，与术前比较差异有显著性意义(P < 0.05)；桡骨高度8.01-13 mm，平均11.03 mm，与术前比较差异有显著性意义(P < 0.05)。末次随访根据Gartland-Werley 评分标准评价患者腕关节功能，本组优8例，良2例，差1例，优良率91%，具体资料见表1。 2.3 典型病例患者63岁，女性，术前诊断：左侧桡骨远端粉碎性骨折(C1型)(图3A-C)，行左侧桡骨远端切开复位内固定术，术后6个月正侧位片显示骨折愈合良好，掌倾角、尺偏角及桡骨高度较术前明显改善(图3D)。 2.4 不良事件 1例52岁右侧桡骨远端粉碎性骨折(C3型)女性，切开复位Acu-Loc®2 VDR骨板内固定术后出现前臂远端不能确定部位的疼痛，间断服用依托考昔消炎止痛，同时使用院内制剂舒筋外洗颗粒外洗患部，6个月后疼痛症状基本消失。该患者骨折断端粉碎，术后石膏固定，目前综合考虑疼痛是因肌腱粘连所致。该病例也提示对于有外固定的患者，应早期抬举上肢，早期行手指、掌指关节功能锻炼，循序渐进行腕关节早期活动，在保证断端稳定的情况上尽早去除外固定，以避免该类并发症的发生。"

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