老年桡骨远端AO-C型骨折手法复位小夹板固定与切开复位内固定临床疗效的对照研究  

Comparative study of manual reduction and small splint fixation and open reduction and internal fixation of distal radius fractures of A-OC type in the elderly

作　　者：邢海昌 刘伟伟[1] 刘红霞[1] 陈延荣[2] XING Haichang;LIU Weiwei;LIU Hongxia;CHEN Yanrong(Orthopaedic Microsurgery Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China)

机构地区：[1]山东中医药大学附属医院放射科,山东济南250014 [2]山东中医药大学附属医院显微骨科,山东济南250014

出　　处：《中国中西医结合影像学杂志》2022年第4期391-394,398,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：山东医药卫生科技发展计划(202009010988)。

摘　　要：目的:对比手法复位小夹板固定与切开复位内固定治疗老年桡骨远端AO-C型骨折的临床疗效。方法:选取59例老年桡骨远端AO-C型骨折患者,随机分为手术组(29例)和夹板组(30例),分析比较2组影像学参数,以及腕关节功能患者自评量表(PRWE)评分。结果:手术组术后1个月与术后3 d、术后6个月各影像学参数(掌倾角、尺偏角、桡骨高度)比较,差异均无统计学意义(均P>0.05)。夹板组术后1个月与术后3 d、术后6个月尺偏角比较,差异无统计学意义(P>0.05);夹板组术后1个月与术后3 d掌倾角、桡骨高度比较,差异均有统计学意义(均P<0.05);术后1个月与术后6个月掌倾角、桡骨高度比较,差异均无统计学意义(均P>0.05)。2组间术后各时间节点影像学参数比较,差异均有统计学意义(均P<0.05)。术后6个月2组PRWE评分比较差异无统计学意义(P>0.05)。结论:切开复位内固定治疗后桡骨远端形态恢复较手法复位小夹板固定更优;手术组术后桡骨远端形态得以稳定保持;骨折愈后腕关节功能评分对比,2种处理方式无明显差别。Objective:To compare the clinical efficacy between in treatment of distal radius fractures in the elderly manual reduction and small splint fixation and open reduction and internal fixation.Methods:A total of 59 elderly patients with distal radius fractures of AO-C type were selected and randomly divided into a surgery group(29 cases)and a splint group(30 cases).After treatment,imaging parameters and patient rated wrist evaluation(PRWE)score were analyzed.Results:There were no significant differences in imaging parameters of the surgery group(palmar inclination angle,ulnar deviation angle,radius height)at 1 month after operation compared with those at 3 days and 6 months after the operation(all P>0.05).There were no significant differences in the ulnar deriation angle of the splint group at 1 month after operation compared with that at 3 days and 6 months after the operation(P>0.05).There were statistically significant differences in palmaral inclination angle and radius height between 3 days and 1 month after surgery in the splint group(all P<0.05),while there were no statistically significant differences in the palm angle and radial height between 1 month and 6 months after surgery in the splint group(P>0.05).Pairwise comparisons were made between the two groups on imaging parameters at each time point after the operation,and the differences were statistically significant(all P<0.05).At 6 months after surgery,the wrist function scores were recorded and compared in the two groups,showing no significant difference(P>0.05).Conclusions:Open reduction and internal fixation have a better morphological recovery of the distal radius than manual reduction and small splint fixation.The morphology of the distal radius remained stable in the surgery group.In terms of the wrist function score,there is no significant difference between the two treatment methods after fracture healing.

关 键 词：桡骨远端骨折 小夹板固定 切开复位内固定 

分 类 号：R687.3[医药卫生—骨科学]