锁定钢板内固定与外固定支架治疗C型桡骨远端骨折的比较  

Locking compression plate versus external fixator for type C distal radius fractures

作　　者：王星亮 华国军[1] 杨家骥 徐志庆 王小龙 刘云鹏[1] WANG Xing-liang;HUA Guo-jun;YANG Jia-ji;XU Zhi-qing;WANG Xiao-long;LIU Yun-peng(Department of Orthopaedics, The lOlst Hospital of PLA, Wuxi 214044, China)

机构地区：[1]解放军第101医院骨科,江苏无锡214044

出　　处：《中国矫形外科杂志》2018年第12期1074-1079,共6页Orthopedic Journal of China

摘　　要：[目的]比较切开复位锁定钢板内固定(LCP)和闭合复位外固定支架(EF)治疗C型桡骨远端骨折的临床疗效。[方法]回顾2014年1月~2016年6月本院同一手术组收治并手术的78例C型桡骨远端骨折患者资料。锁定钢板内固定(LCP)组40例,其中男24例,女16例,年龄34~74岁,平均(57.41±3.31)岁;外固定支架(EF)组38例,其中男性20例,女性18例,年龄35~72岁,平均(56.32±2.51)岁。采用改良Mayo功能评分和影像测量,包括桡骨远端的尺偏角、掌倾角和桡骨高度,评价比较两种手术方法的优劣。[结果]两组患者均顺利接受手术,无血管神经损伤等严重并发症。LCP组手术切口长度、术中失血量明显大于EF组,差异有统计学意义(P<0.05)。所有患者均获随访,平均随访时间(11.55±1.38)个月。末次随访时,Mayo功能评分LCP组(86.13±9.73)分,EF组(84.18±8.44)分,两组间差异无统计学意义(t=1.993,P=0.08)。在术后即刻、术后6周、术后3个月的影像测量方面,LCP组的掌倾角、尺偏角和桡骨茎突高度均大于EF组。[结论]LCP和EF治疗桡骨远端C型骨折均可取得满意的临床疗效,但LCP在维持桡骨高度和尺偏角方面具有更好的优势。[Objective] To compare the clinical outcomes of locking compression plate（LCP） versus external fixator（EF）for type C distal radius fractures. [Methods] A retrospective study was conducted on 78 patients who underwent surgical treatment for type C distal radial fractures by the same medical group in our hospital from January 2014 to June 2016. Of them, 40 patients received open reduction and internal fixation with LCP（the LCP group）, including 24 males and 16 females aged from34 to 74 years with an average of（57.41±3.31） years, while the remaining 38 patients underwent close reduction and external fixation（the EF group）, including 20 males and 18 females aged from 35 to 72 years with an average of 56.32±2.51 years. The Mayo scores, and radiographic measurements, such as palm tilt, ulnar inclination and length of radial styloid, were applied to compare the two group. [Results] All patients had operation performed smoothly without serious complications, such as neurovascular injuries. The LCP group got significantly longer incisions and more blood loss than the EF group（P〈0.05）. All the patients were follow up for an average of（11.55±1.38） months. At the latest follow up, the Mayo scores proved（86.13±9.73） in the LCP group, while（84.18±8.44） in the EF group without a statistical difference between them（t=1.993, P=0.08）. Regarding to radiographic measurements, the palm tilt, ulnar inclination and length of radial styloid in the LCP group were slightly greater than those in the EF group. [Conclusions] Both locking compression plate and external fixator achieve satisfactory clinical outcomes for type C distal radius fractures, however, the volar locking compression plate has an advantage over the external fixator to maintain the palm tilt, ulnar inclination and length of radial styloid.

关 键 词：锁定钢板内固定 外固定 桡骨远端骨折 

分 类 号：R683.41[医药卫生—骨科学]