高活动状态老年人桡骨远端骨折功能预后的影响因素  

Factors influencing functional prognosis of distal radius fractures with high activity status

作　　者：顾伟[1] 孙骏[1] 李志强[1] 卫晓恩[1] GU Wei;SUN Jun;LI Zhiqiang;WEI Xiaoen(Department of Orthopedic,Shuguang Hospital Affiliated to Shanghai University of Chinese Traditional Medicine,Shanghai 200012,China)

机构地区：[1]上海中医药大学附属曙光医院骨科,上海市200012

出　　处：《组织工程与重建外科》2021年第5期405-407,416,共4页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的探索治疗方法及影像学参数对于高活动状态老年人桡骨远端骨折功能预后的影响。方法自2015年6月至2017年6月,在60岁以上的老年桡骨远端骨折患者中,选取既往高活动状态的63名,分为2组,对照组采用手法复位石膏固定的保守治疗(n=31),观察组采用切开复位内固定手术(n=32)。治疗后12周时,记录患者影像学参数;48周时记录患者DASH评分及SF-36量表评分,对数据进行单变量分析及线性回归分析。结果治疗后48周,观察组DASH评分10.9±14.79,对照组11.3±11.93,观察组SF-36评分53.64±6.14,对照组51.99±6.13,均无统计学差异(P>0.05)。影像学参数中,治疗前尺骨差异大于2 mm是治疗后1年评分较低的预测因素。结论在高活动状态老年患者中,手术与保守治疗对于最终功能预后的影响无明显差别;治疗方案的选择应根据患者临床衰弱量表评分及尺骨差异等影像学的表现进行综合分析。Objective To explore the effect of treatment and radiographic parameters on functional prognosis of distal radius fractures in elderly patients with high activity status.Methods From June 2015 to June 2017,63 elderly patients over 60 years of age with previously high activity status were selected.The control group received conservative treatment with manual reduction and plaster fixation(n=31),and the observation group received open reduction and internal fixation(n=32).Radiographic parameters were recorded after treatment and 12 weeks after treatment.DASH scores and SF-36 scale scores were recorded at 48 weeks of follow⁃up.The data was analyzed by univariate analysis and linear regression analysis.Results After 48 weeks of follow⁃up,the DASH score was 10.9±14.79 in the observation group and 11.3±11.93 in the control group,and the SF⁃36 score was 53.64±6.14 in the observation group and 51.99±6.13 in the control group,with no statistical difference.Among radiographic parameters,a pre⁃treatment ulna difference greater than 2 mm was a predictor of a lower one⁃year post⁃treatment score.Conclusion In elderly patients with high activity status,there was no significant difference in the effect of surgical and conservative treatment on the final functional outcome;The choice of treatment should be based on comprehensive analysis of CSHA score and ulna differences and other radiographic findings.

关 键 词：桡骨远端骨折 老年人 功能转归 手术治疗 

分 类 号：R683.41[医药卫生—骨科学]