植骨内固定与支架外固定治疗老年性桡骨远端C型骨折的疗效比较  

A comparison of two methods in treating senile type C fracture of distal radius

作　　者：朱成栋[1] 乔高山[1] 朱乐银[1] 夏建忠[1] 印文彩 

机构地区：[1]江苏省仪征市人民医院(扬州大学医学院附属仪征医院)创伤骨科,江苏仪征211400

出　　处：《生物骨科材料与临床研究》2016年第1期49-52,共4页Orthopaedic Biomechanics Materials and Clinical Study

基　　金：江苏省卫生厅医改项目(Y201314)

摘　　要：目的比较斜T型钢板结合植骨与闭合复位支架外固定治疗老年性桡骨远端C型骨折的临床疗效。方法回顾性分析2008年01月~2014年12月分别采用斜T型钢板配合植骨（内固定组）与闭合复位支架外固定（外固定组）治疗老年性桡骨远端C型骨折的病例共55例,其中内固定组23例,外固定组32例。比较两组术后影像学指标、功能指标,腕关节功能按Gartland-Werley功能评分标准对术后疗效进行评估。结果所有患者均获术后6~18个月（平均10.6个月）随访,内外固定组患者骨折愈合时间分别为7~12周（平均8.3周）、7~16周（平均9.9周）。两组术后6个月掌倾角、尺偏角及桡骨高度较术前比较,差异均有统计学意义（〈0.05）。术后6个月内固定组掌倾角（11.56±4.49）°、桡骨高度（11.21±2.67）mm明显优于外固定组[（7.66±3.73）°、（6.78±2.95）mm],差异有统计学意义（P〈0.05）。术后6个月内外固定组尺偏角[（18.73±5.23）°、（16.02±3.85）°]比较,差异无统计学意义（〉0.05）。末次随访两组腕关节背伸、掌屈、旋前、旋后及Gartland-Werley功能评分相比,差异均有统计学意义（〈0.05）。内固定组和外固定组优良率分别为91.3%（21/23）、78.1%（25/32）;并发症发生率分别为4.34%（1/23）、9.38%（3/32）。两组比较差异有统计学意义（〈0.05）。结论对于老年性桡骨远端C型骨折选择植骨内固定能达到理想复位,能有效防止骨折复位丢失和再移位,临床疗效明显优于闭合复位外固定支架。Objective To compare the clinical results of internal the oblique T-plate plus bone grafting and close reduction plus external fixator in the treatment of senile type C fracture of distal radius. Methods From Jan 2008 to Dec 2014,55 cases who used internal the oblique T-plate plus bone grafting and closed reduction plus external fixator for the treatment of senile type C fracture of distal radius in were followed up and analyzed. Among these 55 cases, internal the oblique Tplate plus bone grafting was used for 23 patients, Closed reduction and external fixation was used for 32 patients. Outcomes on the wrist joints function were assessed after operation by comparison of radiographic parameters and function parameters based on the standard of Gartland-Werley. Results All patients were followed up for 6 to 18 months after operation（average 10.6 months）. fracture healing time for patients using internal and external fixation was（7 to 12） weeks（average 8.3 months）,（7 to 16） weeks（average 9.9 months）. At six months after surgery, compared palmar angle, ulnar deviation and radial height with the preoperative, the difference between the two groups of patients（ 〈0.05） was statistically significance. Internal fixation group within six months after the surgery, palmar angle（11.56±4.49） °, radial height（11.21±2.67） mm was significantly better than external fixation group [（7.66±3.73） °,（6.78±2.95） mm]. The difference was statistically significant（ 〈0.05）. Six months after surgery, both groups ulnar deviation [（18.73± 5.23）°,（16.02±3.85） °], the difference was not statistically significant（ 〉0.05）. After the last follow-up of two groups,compared the scores of palmar flexion, pronation, supination based on the Gartland-Werley function, the differences were statistically significant（ 〈0.05）. The internal fixation and external fixation group, the excellent and good rate was 91.3%（21/23）, 78.1%（25/32）. The complication rate was 4.43%（1/23）,

关 键 词：桡骨骨折 骨折固定术 外固定器 骨板 

分 类 号：R687.3[医药卫生—骨科学]