不同固定方式治疗老年桡骨远端骨折的疗效分析  

Efficacy of Different Fixations in Elderly Distal Radius Fracture

作　　者：张堃[1,2] 米仲祥[1,2] 南学彦[1,2] 廖敏捷[1,2] 刘红喜[1,2] 毕军伟[1,2] 

机构地区：[1]甘肃省中医院创伤骨一科 [2]甘肃中医学院附属一院,兰州730050

出　　处：《中国中医骨伤科杂志》2014年第11期29-31,共3页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的：探讨3种不同方法治疗老年桡骨远端骨折的疗效。方法：采用手法复位小夹板外固定（A组，36例）、切开复位普通“T”钢板（B组，31例）及桡骨远端解剖锁定钢板内固定（C组，26例）等3种不同方法治疗老年桡骨远端骨折93例。比较6个月时桡骨高度、掌倾角、尺偏角，采用改良Gartland—Werley（GW）评分对术后6、12个月的腕关节功能进行评定。结果：随访时间12～24个月，平均20．3个月，骨折愈合时间2～3个月，6个月时A组的桡骨高度及尺偏角较B、C组差，差异有统计学意义，B、C二组间差异无统计学意义（P〉0．05），改良Gw评分A组（6．31±1．17）分与B组（3．81±1．17）分、C组（3．21±1．17）分比较差异有统计学意义（P〈0．05），B、C二组间比较差异无统计学意义（P〉0．05）。术后12个月改良GW评分，3组间比较差异无统计学意义（P〉0．05）。结论：手法复位小夹板外固定治疗老年桡骨远端骨折，早期腕关节功能恢复水平较手术治疗差，但远期功能恢复良好。Objective：To compare the clinical efficacy of three different fixations in elderly distal radius fracture. Methods： All 93 patients of elderly distal radius fracture were treated with manipulative restoration and external fixation （group A, n =36）, opening restoration and T plate internal fixation （group B, n： 31）, or anatomic locking plate internal fixation （group C, n=26）. The radial height, volar tilt, radial inclination were compared, the modified Gartland-Werley scores were used to assess wrist joint function at the 6th and 12th months after the treatments. Results： All patients were followed up from 12 to 24 months, with an average of 20.3 months. All the patients achieved bony union after 2 to 3 months. The radial height, radial inclination and modified Gartland-Werley scores of group B and C were significantly better than group A at the 6th month, but there was no statistical significance between group B and group C. The modified Gartland-Werley scores of three groups were no statistical difference at the 12th months after the treatments. Conclusion：The effect of ma- nipulative restoration and external fixation is worse in the early stage of elderly distal radius fracture, but is become better after the 12th months.

关 键 词：桡骨远端骨折 手法复位 外固定 内固定 

分 类 号：R683.41[医药卫生—骨科学]