背側転位型橈骨遠位端骨折に対する掌側ロッキングプレート固定の治療成績

Clinical Results of Volar Locking Plate Fixation for Dorsally Displaced Fractures of the Distal Radius

　Condylar stabilizing法を施行した背側転位型橈骨遠位端骨折31例31骨折を対象にX線形態計測，自動関節可動域，握力の推移について調査した．尺側傾斜，掌側傾斜，尺骨変異の整復位損失は，0.2°，0.7°，0.8mmであった．術後12週までに手関節背屈は健側比87％，掌屈81％，回外91％，回内95％，握力79％に回復した．手関節尺側部痛を7例に認めた．TFCC損傷が原因と考え，手関節鏡でDRUJ不安定性を生じさせるようなTFCC損傷の有無を確認している．

　Thirty-one patients with dorsally displaced fractures of the distal radius, including 14 extra-articular and 17 intra-articular fractures, were treated wing volar locking plate systems at our institution. Eight men and 23 women with a mean age of 60.9 years (range：28-83 years) were treated. The outcomes were evaluated according to range of motion, grip strength, and a radiological assessment to measure ulnar inclination (UI), volar tilt (VT), and ulnar variance (UV). The mean follow-up period was 27 weeks (range：12-88 weeks). The mean range of motion of the injured wrist, compared to that of the uninjured wrist, 12 weeks after the operation was 87％ for dorsiflexion, 81％ for volarflexion, 88％ for radial deviation, 87％ for ulnar deviation, 91％ for supination, and 95％ for pronation. The mean grip strength of the affected hand at the final evaluation was 79％ of that of the uninjured hand. At the final follow-up examination, the average loss of correction for UI, VT and UV was 0.2°, 0.7°, and 0.8mm, respectively.