掌侧钢板结合外固定架治疗老年桡骨远端C3型骨折  

A Comparative Study of Type C3 Distal Radius Fracture Treated by Volar Plate in Combination with External Fixator in Elderly Patients

作　　者：赵铭[1] 张月东[1] 宁鹏[1] 尚凯[1] 张杰锋[1] 王军[1] 

机构地区：[1]山东省泰安市中心医院创伤骨科,山东泰安271000

出　　处：《实用骨科杂志》2014年第8期697-700,共4页Journal of Practical Orthopaedics

摘　　要：目的：比较掌侧钢板结合外固定架和闭合复位石膏外固定治疗老年桡骨远端 C3型骨折的临床疗效。方法分析本院2006年7月至2012年12月收治的老年桡骨远端 C3型骨折62例，31例采用掌侧钢板结合外固定架手术治疗，31例采用闭合复位管型石膏外固定保守治疗。两组均在术后12个月行 X 线片检查，测量桡骨远端掌倾角、尺偏角及桡骨高度。腕关节功能评分采用 Krimmer 评分和患者主观功能评价臂肩手功能缺陷，用于了解术后腕关节功能受限程度以及患者主观感受，对手术和保守治疗效果进行评价。结果62例患者均获得随访，随访时间12-18个月，平均14.8个月。术后12个月，手术组患者掌倾角、尺偏角和桡骨远端高度显著优于保守治疗组（P ﹤0.01）；手术组患者腕关节伸屈、旋转、尺桡偏的角度、手的握力均大于保守治疗组（P ﹤0.01）；Krimmer 评分和 DASH 评分手术治疗组优于保守治疗组（P ﹤0.05）；两组患者 VAS 痛觉评分没有明显区别（P ﹥0.05）。结论对于桡骨远端 C3型骨折的老年患者，首选手术治疗，掌侧支撑钢板结合外固定架治疗可以取得良好的效果。Objective To compare the clinical outcomes of volar plate in combination with external fixator（VPEF）and closed reduction plus plaster immobilization（CRPI）for the management of type C3 distal radius fractures in elderly patients. Methods In our study,the clinical data of 62 elderly patients with type C3 distal radius fracture in our hospital from July 2006 to December 2012 were evaluated. 31 patients were treated by volar plate in combination with external fixator,wheres the other 31 patients treated by closed reduction plus plaster immobilization. The functional outcomes and radiological results were compared between the two groups. The range of motion and grip strength were measured. Radiographic parameters（Palmar tilt, palmar inclination and radial length）were measured. Wrist scores according to Krimmer score and the DASH questionnaire were used. Results 62 cases were all followed up,mean follow-up period was 14. 8 months（12 - 18 months）. The radiograph-ic parameters and functional parameters showed significant differences between the groups（ P ﹤ 0. 01）. The VPEF group showed the most positive results. According to Krimmer and DASH score,there were significantly better results in the VPEF group in comparison to the CRPI group（P ﹤ 0. 01）. There was no statistically significant difference in visual analogue scale （VAS）pain score between the two groups. Conclusion Volar plate in combination with external fixator is an effective treat-ment for type C3 distal radius fractures in elderly patients.

关 键 词：桡骨远端骨折 外固定架 掌侧钢板 闭合复位 

分 类 号：R683.41[医药卫生—骨科学]