桡骨远端骨折手术治疗的临床观察  

Clinical observation on the surgical treatment of distal radius fractures

作　　者：平建锋[1] 孙文东[1] 车斌[1] 胡旭军[1] 钱宇[1] 

机构地区：[1]浙江省绍兴市人民医院骨科,312000

出　　处：《中华全科医学》2015年第11期1782-1783,1823,共3页Chinese Journal of General Practice

基　　金：浙江省科技厅公益性计划项目(2011C33024);浙江省自然基金计划项目(Y2110653)

摘　　要：目的传统石膏、小夹板固定及功能锻炼等方法并不能很好的恢复桡骨远端骨折的解剖位置和功能。文章为了进一步提高桡骨远端骨折的治疗效果,分析采取手术治疗的优势和可行性。方法将2011年3月—2012年9月期间来绍兴市人民医院骨科就诊的203例桡骨远端骨折患者按照患者及家属意愿分为观察组和对照组,其中观察组患者71例,治疗上采取手术治疗,对照组患者132例,治疗上采取保守治疗。观察组和对照组患者分别在1个月、3个月、6个月、12个月的时候进行影像学复查,测量掌倾角及尺偏角的大小,对比2组患者在各时间点影像学表现的评分差异;观察组和对照组患者在治疗后1个月复查关节功能恢复情况,对比2组患者握力及畸形评分差异。结果观察组患者在1个月、3个月、6个月、12个月的影像学表现评分别为(33.9±8.5)分、(34.0±8.5)分、(34.1±8.6)分、(34.2±8.6)分,明显高于对照组[(32.8±8.2)分,(33.1±8.3)分,(32.9±8.2)分,(33.1±8.3)分];观察组患者在手术治疗后1月,握力评分为(18.8±4.7)分,畸形评分为(0.9±0.3)分,对照组握力评分为(17.5±4.4)分,畸形评分为(1.1±0.3)分,差异具有统计学意义(P<0.05)。结论对于桡骨远端骨折患者采取手术治疗,有利于患者骨折部位关节功能恢复和解剖结构复位,效果显著,值得借鉴推广。Objective The traditional gypsum board, small splint fixation and functional exercisecould all not lead to better restoration of the anatomic location and function of the broken bone in patients with distal radius fracture. The aim of this paper is to evaluate the advantages and feasibilityof surgical treatment and further improve therapeutic efficacy of the distal radius fracture. Methods From March 2011 to September 2012,203 cases of distal radius fracture in the department of orthopedics of our hospitalwere enrolled and divided into observation group and control group, including 71 cases in the observation group received the surgical treatment, and 132 cases in the control group receivedtheconservative treat- ment. The image examinations were performed to measure theradial inclination angle and ulnar deviation in all patientsat 1,3,6 and 12 months after the surgery, and the neurological differences at each time point were compared between the two groups ;The recovery of joint function was checked at 1 month after the surgery in allpatients and the difference in the grip strength and deformity score were compared between the two groups. Results The imaging study scoresat 1,3,6 and 12 months after the surgery was （33.9 ± 8.5 ）, （34 ± 8.5 ）, （34.1± 8.6） and（ 34.2 ±8.6） in the observation group, which was significantly higher than （32.8 ±8.2）, （331 1 ±8.3）, （32.9±8.2）and （33.1±8.3） in the control group;One month after the surgery,the grip strength and deformity score in the observation group were （18.8±4.7） and （0.9 ±0.3 ）, respectively, which were higher than （ 17.5 ± 4.4） and （ 1.1 ± 0.3 ） in the control group, the difference was significant（P 〈 0.05 ）. Conclusion Thesurgical treatment for distal radius fracture can achieve a satisfactory outcome in restoration of the anatomic location and function of the broken bone,which isworthy of being popularized.

关 键 词：桡骨骨折 手术治疗 外固定 疗效 

分 类 号：R683.41[医药卫生—骨科学]