植骨内固定与闭合复位支架外固定治疗桡骨远端C型骨折疗效比较  

Comparison of the curative effect between bone autograft with internal fixation and closed reduction with external fixator in treatment of type C distal radius fractures

作　　者：朱成栋 乔高山 朱乐银 夏建忠 印文彩 

机构地区：[1]仪征市人民医院创伤骨科,江苏仪征211400

出　　处：《临床骨科杂志》2016年第4期496-499,共4页Journal of Clinical Orthopaedics

基　　金：江苏省卫生厅医改项目(编号:Y201314)

摘　　要：目的比较植骨内固定与闭合复位支架外固定治疗桡骨远端C型骨折的临床疗效。方法对38例桡骨远端C型骨折患者分别采用植骨内固定（17例）与闭合复位支架外固定（21例）治疗。比较两组术后影像学指标,腕关节功能按Gartland-Werley功能评分标准进行评价。结果患者均获得随访,时间6-18个月。术后3个月掌倾角、桡骨高度内固定组均优于外固定组,差异均有统计学意义（P〈0.05）。末次随访腕关节背伸、掌屈、旋前、旋后及Gartland-Werley功能评分内固定组均优于外固定组,差异均有统计学意义（P〈0.05）。腕关节功能评估：内固定组优6例,良9例,可2例,优良率15/17;外固定组优4例,良10例,可5例,差2例,优良率14/21;两组差异有统计学意义（P〈0.05）。结论植骨内固定治疗桡骨远端C型骨折能达到理想复位,能有效防止骨折复位丢失和再移位,临床疗效优于闭合复位支架外固定。Objective To compare the clinical effect of the oblique T-plate plus bone grafting and close reduction plus external fixator in the treatment of type C fracture of distal radius. Methods Thirty-eight cases with type C distal radius fractures were treated by internal fixation（ n = 17）,with bone graft and external fixator（ n = 21）. Postoperative radiographic parameters,wrist function by Gartland-Werley score evaluation criteria were compared. Results Patients were followed up for 6 - 18 months. Within 3 months after surgery,internal fixation group with volar tilt,radial height was superior to external fixation group,the differences were statistically significant（ P〈0. 05）. At the last follow-up,internal fixation group of wrist dorsiflexion,palmar flexion,pronation,supination and Gartland-Werley score were better than external fixation group,the differences were statistically significant（ P〈0. 05）. Wrist function assessment： internal fixation group was excellent in 6 cases,good in 9,fair in 2,excellent-good rate was 15 /17; external fixation group was excellent in 4 cases,good in 10,fair in 5 and poor in 2,excellent-good rate was 14 /21. Excellent-good rate between the two groups was statistically significant（ P〈0. 05）. Conclusions Internal plating plus bone grafting may result in better results than close reduction plus external fixator for type C fracture of distal radius.It can effectively prevent the loss of reduction and fracture displacement.

关 键 词：桡骨远端骨折 内固定术 外固定器 植骨 

分 类 号：R683.41[医药卫生—骨科学] R687.3[医药卫生—外科学]