X线分型对老年人Colles骨折治疗策略及预后的价值研究  

Value of X-ray Classification on Therapeutic Strategies and Prognoses for Colles Fracture in the Elderly

作　　者：方媛[1,2] 蒋定尧[1] 龚向阳[3] 周晓玲[4] 

机构地区：[1]浙江大学医学院附属第二医院放射科,杭州310009 [2]宁波市第六医院放射科,315040 [3]浙江省人民医院放射科 [4]宁波市第六医院手外科

出　　处：《临床放射学杂志》2016年第10期1560-1565,共6页Journal of Clinical Radiology

摘　　要：目的探讨X线分型在老年人Colles骨折治疗策略选择及预后评估中的价值。方法对44例60岁以上Colles骨折患者进行纵向回顾性研究。根据Frykman分型将病例分为关节内型骨折组（26例）和关节外型骨折组（18例）。关节内型骨折组接受保守治疗11例,手术治疗15例;关节外型骨折组接受保守治疗10例,手术治疗8例。所有患者在受伤后治疗前、治疗后1周、2周、6-8周均行腕关节X线平片检查。测量所有患者复位前后X线平片的桡骨掌倾角、桡骨尺偏角、桡骨短缩值。骨折愈合的影像学结果应用Lidstrom分级进行评价。统计并比较两组患者保守治疗、手术治疗结果。结果按照Lidstrom分级,44例Colles骨折患者经治疗后75.0%的影像学结果可接受。其中关节内型骨折组与关节外型骨折组可接受率分别为76.9%、72.2%,两组比较差异无统计学意义（P=0.723）。关节内型骨折组保守治疗与手术治疗的可接受率分别为54.5%和93.3%,两种治疗方式差异有统计学意义（P〈0.05）;关节外型骨折组保守治疗与手术治疗的可接受率分别为60.0%和87.5%,两种治疗方式差异无统计学意义（P〉0.05）。结论老年人Colles骨折患者,关节内型手术治疗效果优于保守治疗,关节外型保守治疗与手术治疗效果相仿。Objective To determine the value of X-ray classification on therapeutic strategies and prognoses for Colles fracture in the elderly patients（ ≥60 years） by comparing and analyzing the radiographic functional outcomes of Colles fracture in the elderly patients with conservative and operative treatment. Methods From Jan 2012 to Apr 2015,44 cases with Colles fracture in the elderly patients were retrospectively studied. They were 7 men and 37 women,aged from 60 to85 years（ average 69 years）. Patients were divided into intra-articular fracture group（ 26 cases） and extra-articular fracture group（ 18 cases） by the Frykman classification. According to the treatment method,intra-articular fracture group and extra-articular fracture group can be divided respectively into conservative treatment（ 11 cases）,（ 10 cases） and operative treatment（ 15 cases）,（ 8 cases）. All patients were radiographically followed-up weekly initially,1 week post-reduction,2and 6-8weeks post-reduction. The radial volar tilts,radial inclination and radial shortening in the X-rays were measured by the Kreder method. The radiographic functional outcomes were evaluated by the Lidstrom grading system and documented and compared between the 2 groups with conservative and operative treatment. Results By Lidstrom grading system,75. 0% of the fractures achieved acceptable radiographic outcomes after treatment. The rates of acceptable outcomes were respectively 76. 9% and 72. 2% in the intra-articular fracture group and extra-articular fracture group,with no statistically significant difference between the 2 groups（ P = 0. 723）. The rates of acceptable outcomes for the intra-articular fracture were respectively 54. 6% and 93. 3% in the conservative and operative treatment groups; the rates of acceptable outcomes for the extra-articular fracture were respectively 60. 0% and 87. 5% in the conservative and operative treatment groups.There were statistically significant differences between the conservative and operative trea

关 键 词：COLLES骨折 保守治疗 手术治疗 放射摄影术 

分 类 号：R687.3[医药卫生—骨科学] R816.8[医药卫生—外科学]