解剖锁定钢板内固定与保守治疗对老年性 桡骨远端C型骨折的临床疗效比较  

Comparison of the clinical efficacy of anatomic locking plate fixation with conservative therapy in treatment of C type distal radius fractures in senile patients

作　　者：刘安成[1] 

机构地区：[1]菏泽市立医院骨科,山东菏泽274000

出　　处：《实用手外科杂志》2016年第4期453-456,共4页Journal of Practical Hand Surgery

摘　　要：目的 比较解剖锁定钢板内固定与保守治疗两种方式治疗老年桡骨远端C型骨折的临床疗效.方法 2011年3月-2014年3月收治51例桡骨远端C型骨折的老年患者,按治疗方式分为两组,A组行切开复位掌侧解剖锁定钢板内固定手术;B组行闭合手法复位高分子石膏固定术.通过影像学资料比较桡骨远端各项指标恢复情况;患侧腕关节的疼痛程度用视觉模拟评分表（VAS）来评估;腕关节的功能恢复情况采用改良Gartlangd-Werlery评分系统及PRWE评分标准来评估.结果 在掌倾角、尺偏角、桡骨缩短长度及关节面塌陷程度等桡骨远端指标恢复方面,两组术后与术前比较均明显改善（P〈0.05）.末次随访时,A组各项值优于B组（P〈0.05）;末次随访时,A组的VAS评分低于B组,差异有统计学意义（P〈0.05）;Gartlangd-Werlery评分优良率比较,A组的优良率为88.5%,B组为75.0%,差异具有统计学意义（P〈0.05）;A组的PRWE评分低于B组（P〈0.05）.结论 切开复位解剖锁定钢板内固定能更好地恢复和维持桡骨远端掌倾角、尺偏角、桡骨茎突高度及关节面平整度,减少桡骨缩短长度,从而使腕关节功能恢复更优,还能更有效减轻关节疼痛,减轻患侧腕关节创伤性关节炎症状,是治疗该病一种更有效的方法,值得广泛推广应用.Objective To Compare the clinical efficacy of anatomic locking plate fixation with conservative therapy in treatment of C type distal radius fractures in senile patients. Methods From March 2011 to March 2014 we treated 51 senile patients of C distal radius fractures, according to the different treatment divided them into two groups： volar locking plate fixation treatment group （A） and conservative treatment group （group B）, to compare the indicators of the distal radius by their image data; to assess wrist pain by VAS; take Gartlangd-Werlery modified scoring system and PRWE to assess wrist function recovery. Results In the indicators of the distal radius ,such as the volar tilt angle, radial inclination, radial shortening and the articular surface collapse, those of wo groups were significantly improved after treatment （P〈0.05）, at the end of follow-up, group A was better than group B （P〈0.05）; at last follow, the VAS scores of group A was lower than group B （P〈0.05）; in Gartlangd-Werlery score good and excellent rate in group A was 88.5%, 75.0% in group B, the difference was statistically significant （P〈0.05）; the PRWE score of group A was lower than group B （P〈0.05）. Conclusion Both two programs can be an effective treatment of senile C type distal radius fractures, but Anatomical locking plate fixation can better restore and maintain the indicators of the distal radius so that the wrist joint function can recover better.

关 键 词：老年桡骨远端C型骨折 解剖锁定钢板 保守治疗 

分 类 号：R683.41[医药卫生—骨科学]