两种内固定方法治疗桡骨远端骨折的疗效比较研究  

Comparison of the therapeutic effects of two kinds of internal fixation for distal radial fractures

作　　者：张殿英[1] 傅中国[1] 王天兵[1] 姜保国[1] 

机构地区：[1]北京大学人民医院创伤骨科,北京100044

出　　处：《中华手外科杂志》2010年第6期340-343,共4页Chinese Journal of Hand Surgery

基　　金：基金项目：国家自然科学基金（30973066）,十一五科技支撑计划（2007BA104800）,首都医学发展科研基金资助项目（2007-2011）

摘　　要：目的对比斜T型锁定加压接骨板系统（locking compression plate，LCP）及AO普通T型板钉系统治疗桡骨远端骨折的疗效。方法对1999年3月至2009年12月我科收治的313例桡骨远端骨折患者中获得完整随访资料的72例（73侧），采用Sarmiento改良的Gartland—Werley评分系统（CW评分）进行术后功能评分，并比较LCP（I^P组）及AO普通T型板钉系统（普通组）内固定术后两组腕关节的功能。结果术后随访时间为3个月至6年，平均25．4个月。X线片显示骨折全部愈合。GW评分LCP组平均1．98分，普通组平均1．43分，两组差异无统计学意义（P〉0．05）；两组在患者满意度上差异也无统计学意义（P〉0．05）。结论对于绝大部分复位失败的桡骨远端A型骨折、移位明显的B型骨折及C型骨折，应用AO普通T型板钉固定就可满足手术需要，而对于骨质疏松严重的粉碎性C型骨折，LCP的内固定效果更为可靠。Objective To compare therapeutic effects of oblique T-locking compression plate system （LEP） and general AO T-plate and screw system-for treatment of distal radius fractures. Metbods From March 1999 to December 2009, 313 cases of distal radial fractures were treated with LCP or AO T-plate and screw system in our department, were follow-up. Postoperative functional score were performed by Sarmiento modified Gartland-Werley scoring system （GW score） was used to assess the postoperative functions in 72 （73 wrists） cases with complete follow-up. Wrist joint function was compared between patients who underwent LCP fixation （LCP group） and patients who underwent AO T-plate and screw system fixation （routine group）. Results The follow-up time was 3 months to 6 years, with an average of 25.4 months. Bone union was seen in X-rays of all cases. The average score of the LCP group was 1.98 points, and the AO T-plate and screw system group was 1.43 points. There was no significant difference between the two groups （ P 〉 0.05）, and the differences of patient satisfaction between the two group were not notable either （ P 〉 0.05）. Conclusion AO T- plate and screw system is suitable for majority of type A fractures with failed manipulative reduction, type B fractures with obvious displacement, and type C fractures. LCP fixation is more reliable for type C comminuted fractures with osteoporosis.

关 键 词：桡骨骨折 骨折固定术 内 病例对照研究 板钉固定 LCP 

分 类 号：R686[医药卫生—骨科学]