桡骨远端掌侧钢板螺钉固定方向对关节面稳定性的影响

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Abstract Objective Volar locking plate is recognized as an effective instrument for distal radius fractures.But different direction of the screw for multidirectional lock provide varying degree of support.Our study aim to discuss the relationship between the fuction of the wrist joint and the distal multidirectional locking screw direction. Methods The random control trial were used.100 patients with distal radius fractures type C were divided into toe groups (50 patients each).SF-36 score PatientRated Wrist Evaluation (PRWE) score and Disability of Arm Shoulder and Hand (DASH) score were used as assess index system.All the distal screw were parallel on horizontal plane，and were perpendicular to radial diaphysis in group A on sagittal plane and were parallel to wrist joint surface of radius in group B on sagittal plane.The follow up from the pro-operation to the 2nd week，3rd month and 12th month after operation.The enumeration data were analyzed using the Chi-square test and the measurement data were statistically treated using t test with a two-sided significance level of 0.05.Results All the 100 patient were followed as the study design.The postoperative complications between groups show no statistical difference.The SF-36 score，the DASH score and the PRWE score in every time point are not significant different.But the subgroup analysis of serious osteoporosis on the 12th month post operation showed significant difference，on the 3rd month the DASH score and the PRWE score were significantly different.Conclusion The distal multidirection design give the surgeon more freedom during the operation.The screw direction affect the supporting strength.The radiological alignment have little relationship with the wrist joint function.Serious osteoporosis show great probability of radiological alignment failure.Parallel distal screws parallel to wrist joint surface of radius were recommend to get better joint function.

Key words： distal radius fracture volar locking plate multidirectional locking disability of arm shoulder and hand scroe

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2017/V23/I9/798

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