两种固定方法治疗老年不稳定性桡骨远端Colles骨折的疗效分析与评价  

Analysis and Evaluation on the Efficacy of Two Different Methods for the Treatment of Instability Colles Fracture of the Distal Radius in Elderly

作　　者：张辉 袁治国 邵建军 王冠 朱涛 白登彦 

机构地区：[1]甘肃省第二人民医院,兰州730000

出　　处：《中国中医骨伤科杂志》2016年第10期20-23,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:评价70岁以上不稳定性桡骨远端Colles骨折患者闭合复位管形石膏固定与切开复位掌侧锁定钢板固定的临床疗效。方法:回顾性分析2008年8月至2014年7月收治的124例70岁以上不稳定性桡骨远端Colles骨折患者,分别采用中医手法整复管形石膏固定与切开复位掌侧锁定钢板固定两种方法治疗,对其进行客观评估、主观功能效果评价和放射学评价。结果:所有患者均获得6~18个月随访,Colles骨折病人经开放复位掌侧锁定钢板内固定后的放射学结果(掌倾、尺偏和桡骨短缩)明显有差异于管形石膏固定组(P<0.05),两组间PRWE,DASH和Green-OBrien评分等临床效果没有明显差异,管形石膏组病人的疼痛程度明显低于切开复位内固定组。结论:大于70岁的老年病人不论手术与否,其主观和功能效果没有明显差异,老年病人放射学结果不满意不影响功能效果,该类病人可选用非手术处理。Objective：To evaluate the clinical effect between closed reduction while tubular plaster fixation and open reduc- tion while volar locking plate fixation for the treatment of instability Colles fracture in patients over 70 years old. Meth- ods： All 124 cases with instability Colles fracture over 70 years old were retrospective analysis from August 2008 to J uly 2014. They were treated with closed reduction while tubular plaster fixation and open reduction while volar locking plate fixation. The objective evaluation, subjective function effect, and radiological evaluation were evaluated. Results： They were all followed--up for 6 to 18 months. The radiology results of internal fixation group was superior to the plaster fixa- tion group （P^0.05）. But the degree of pain in the plaster fixation group was obviously lower than the internal fixation group （P〈0.05）. The active range, PRWE, DASH, and Green-O＇Brien score were not significantly different between the two groups （P〉0.05）. Conclusion：The subjective and functional results are not significantly different whether sur- gery or not in patients over 70 years old. The unsatisfied radiology results are not affecting their function, so these pa- tients can choose non-surgical treatment.

关 键 词：老年不稳定性 桡骨远端Colles骨折 手术治疗 临床研究 

分 类 号：R683.41[医药卫生—骨科学]