接骨板内固定与手法复位石膏外固定治疗老年桡骨远端关节内骨折的疗效比较  

Comparison of efficacy between plate fixation with manual reduction and plaster external fixation in elderly intra-articular distal radial fractures

作　　者：马永刚[1] 王伟[2] 王坤正[2] Ma Yonggang;Wang Wei;Wang Kunzheng(The Second Bone Two Division, Hospitl of Yulin City, Shaanxi Province, Yulin 719000, China;Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an 710004,China)

机构地区：[1]陕西省榆林市第二医院骨二科,719000 [2]西安交通大学医学院第二附属医院骨一科,710004

出　　处：《中华老年骨科与康复电子杂志》2017年第2期65-69,共5页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：国家自然科学基金(81472068)

摘　　要：目的比较接骨板内固定与手法复位石膏外固定治疗老年桡骨远端关节内骨折的临床疗效。方法回顾性分析2010年3月至2014年10月榆林市第二医院门诊及住院部治疗的桡骨远端B型及C型骨折患者共70例,其中采用接骨板内固定手术治疗的患者32例(接骨板内固定组),手法复位石膏外固定治疗的患者38例(手法复位石膏外固定组),术后两组患者均进行系统康复训练,分析并比较两组患者的Gartland-Werley腕关节功能评分。结果所有患者均获得成功随访,接骨板内固定组随访时间为9~12个月,平均(11±2)个月;石膏外固定组为8~12个月,平均(11±2)个月。Gartland-Werley腕关节功能评分,接骨板内固定组为(4.8±1.2)分,32例患者中优16例、良11例、可3例、差2例,优良率为84%;石膏外固定组为(7.3±1.3)分,优13例,良10例,可9例,差6例,优良率为61%。石膏外固定患者的Gartland-Werley腕关节功能评分及优良率均优于接骨板内固定组,差异均具有统计学意义(t=-7.983,P<0.01;x^2=6.460,P<0.05)。结论对于老年桡骨远端关节内骨折,采用接骨板内固定手术治疗效果优于传统手法复位石膏外固定治疗。Objective To compare the clinical efficacy of internal plate fixation with manual reduction and plaster external in elderly intra- articular fracture of distal radius. Methods A retrospective analysis was performed in 70 cases of outpatients and hospitalized distal radius fracture with type B and type C from 2010 to 2014 in hospital of Yulin City, they were divided into two groups according to different treatment methods, with 32 cases in plate internal fixation group and 38 cases in manipulative reduction and plaster external fixation group. All patients received postoperative rehabilitation systematically, Compared the Gartland-Werley wrist function score between the two groups. Results Patients in plate internal fixation group were followed-up with a timespan of 9-12 months (11±2 months on average), patients in external fixation group were followed-up with a time span of 8-12 months (11±2 months on average). The Gartland-Werley wrist score of internal fixation group was 4.8 ± 1.2, according to Gartland-Werley wrist score, 16 cases were excellent, 11 good, 3 fair and 2 poor, with the excellent rate of 84% . The Gartland-Werley wrists core of plaster external fixation group was 7.3±1.3, 13 cases were excellent, 10 good, 9 fair, 6 poor, with the excellent rate of 61%. The excellent rate were statistically significant different between two groups (c2=6.460, P<0.05), as well as Gartland-Werley wrist score (t=- 7.983, P<0.05). Conclusion Internal plate fixation is superior than the traditional manual reduction and plaster external fixation in Senile articular distal radial fractures.

关 键 词：桡骨骨折 老年人 骨折固定术 内固定器 外固定器 

分 类 号：R683.4[医药卫生—骨科学]