两种内固定方法治疗尺桡骨中段双骨折的预后比较  

Clinical Comparison and Research of Two Methods of Treatment to Diaphyseal Fractures of the Forearm

作　　者：王龙[1] 王业华[1] 赵德勇[1] 刘勇[1] 王召[1] 

机构地区：[1]徐州医学院附属医院骨科,江苏徐州221004

出　　处：《中国医药指南》2014年第4期35-37,共3页Guide of China Medicine

摘　　要：目的对比尺桡骨双钢板固定和尺骨髓内钉加桡骨钢板固定治疗尺桡骨中段双骨折的临床疗效。方法我院于2007年7月至2011年12月,共收治前臂双骨折患者57例,平均随访24.3个月,对其进行回顾性分析。其中,28例患者行尺桡骨双钢板固定,29例患者行尺骨髓内钉加桡骨钢板固定。比较两组患者手术时间、切口长度、骨愈合情况及时间、术后前臂旋转功能恢复情况(Grace-Eversmann评分)以及术后并发症情况。结果两组患者的骨愈合时间以及Grace-Eversmann评分差异无统计学意义,两组患者各有1例发生骨不连。共有10例患者出现术后并发症,其中双钢板组6例,尺骨髓内钉加桡骨钢板组4例。结论尺桡骨双钢板固定和尺骨髓内钉加桡骨钢板固定对于尺桡骨中段双骨折都可以获得满意疗效,但尺骨髓内钉加桡骨钢板创伤相对较小,手术操作简单,在生物力学和生物学固定上达到良好的组合,是一种比较适合的治疗方法。Objective To compare open reduction and internal fixation using dual plating to a hybrid fixation construct with intramedullary nailing of the ulna and plate fixation of the radius in both-bone forearm fractures. Methods A total of 57 skeletally mature individuals treated surgically for acute both-bone forearm fractures between July 2007 and December 2011. 28 patients were treated with dual plate fixation, and 29 patients were treated using a hybrid fixation construct. We compared the clinical outcomes of the two groups by Time to union, range of motion as assessed using a Grace-Eversmann score, and presence of complications. Results There was no significant difference in either time to union or Grace-Eversmann scores between the 2 groups. There was 1 nonunion in each of the 2 groups. Ten overall complications, outside nonunions, were reported：6 in the dual plating group and 4 in the hybrid fixation group. Conclusion Ulnar intramedullary nailing and radial plate group was recommended as the preferred method because of the operation was simple, fewer trauma, achieve the best combination in the biomechanical and biological fixation. So it is recommended as the suitable method.

关 键 词：尺桡骨双骨折 髓内钉 切开复位内固定 

分 类 号：R683.41[医药卫生—骨科学]