掌侧锁定板内固定与克氏针外固定治疗桡骨远端骨折的疗效比较  

Therapeutic efficacy comparison of volar locking plate internal fixation and Kirschner wire external fixation in treating distal radius fractures

作　　者：黄永平 林曦[2] 练佛根 Huang Yongping;Lin Xi;Lian Fogen(Department of Surgery,Jianning General Hospital,Sanming Fujian 354500,China;Department of Orthopaedics,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建省建宁县总医院外科,福建三明354500 [2]福建省立医院骨科,福州350001

出　　处：《保健医学研究与实践》2022年第12期53-56,共4页Health Medicine Research and Practice

基　　金：福建省自然科学基金计划项目(2022J01121849)。

摘　　要：目的 对比掌侧锁定板内固定与克氏针外固定治疗桡骨远端骨折的疗效。方法 选取福建省建宁县总医院2019年4月—2021年4月收治的60例桡骨远端骨折患者,采用随机数字表法分为克氏针组和钢板组,每组30例。克氏针组患者给予克氏针钢丝外固定治疗,钢板组患者给予掌侧锁定板内固定治疗,比较2组患者治疗效果及安全性等指标。结果 克氏针组患者手术时间、住院时间短于钢板组,掌斜角小于钢板组,差异均有统计学意义(P<0.05);2组患者桡骨高度和尺偏角比较,差异无统计学意义(P>0.05)。克氏针组与钢板组患者治疗总有效率分别为96.67%和90.00%,差异无统计学意义(χ^(2)=0.268,P=0.605)。克氏针组患者并发症发生率为6.67%,低于钢板组的33.33%,差异有统计学意义(χ^(2)=6.667,P=0.010)。结论 掌侧锁定板和克氏针外固定治疗桡骨远端骨折均取得较好临床效果,其中克氏针外固定治疗操作简单,患者术后恢复快,在缩短患者住院时间,降低住院费用及预防并发症发生方面效果更好,而掌侧锁定板则对桡骨正常形态、掌斜角和关节面复位具有较好的治疗效果。对于合并骨质疏松或桡骨远端粉碎性骨折患者尽量采用外固定治疗,对于年轻患者建议内固定恢复桡骨远端正常形态和关节面的平整度,以降低远期并发症发生风险。Objective To compare the efficacy of volar locking plate internal fixation and Kirschner wire external fixation in the treatment of distal radius fractures.Methods Sixty patients with distal radius fractures admitted to Jianning General Hospital from April 2019 to April 2021 were randomly assigned to the Kirschner wire group and the plate group,with 30 cases in each group.Patients in the Kirschner wire group underwent Kirschner wire external fixation,and patients in the plate group;volar locking plate internal fixation.The therapeutic efficacy and safety were compared between the two groups.Results The operation time and length of hospital stay of patients in the Kirschner wire group were shorter than those in the plate group;the palmar oblique angle was smaller than that in the plate group,with statistical significance(P<0.05).There was no significant difference in radial height and ulnar deviation angle between the two groups(P>0.05).The overall response rate was 96.67% and 90.00% in the Kirschner wire group and the plate group,respectively,without statistical significance(χ^(2)=0.268,P=0.605).The incidence of complications in the Kirschner wire group was 6.67%,which was lower than that in the plate group(33.33%),with statistically significant differences(χ^(2)=6.667,P=0.010).Conclusion Both the volar locking plate and Kirschner wire demonstrate good clinical efficacy in treating distal radius fractures.Kirschner wire treatment is simple,which is conducive to facilitating postoperative recovery,shortening the length of hospital stay,reducing hospitalization costs,and preventing complications.The volar locking plate shows better therapeutic efficacy on the normal shape of radius,palmar oblique angle,and articular surface reduction.For patients with osteoporosis or comminuted distal radius fractures,external fixation should be adopted as far as possible.For young patients,internal fixation is recommended to restore the normal shape of the distal radius and the flatness of the articular surface to reduce the ris

关 键 词：桡骨远端骨折 掌侧锁定板 克氏针钢丝 关节面复位 桡骨形态 

分 类 号：R683.41[医药卫生—骨科学]