内固定和外固定治疗桡骨远端骨折患者临床观察  

Clinical Observation of Patients with Distal Radius Fracture Treated with Internal Fixation and External Fixation

作　　者：涂世成 李仕昂 杜浩[1] TU Shicheng;LI Shiang;DU Hao(Department of Orthopedics,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang Henan 471003,China)

机构地区：[1]河南科技大学第一附属医院骨科,河南洛阳471003

出　　处：《河南医学高等专科学校学报》2023年第4期369-373,共5页Journal of Henan Medical College

摘　　要：目的探究内固定和外固定治疗桡骨远端骨折对腕关节功能恢复及活动度的作用。方法选取68例桡骨远端骨折患者作为研究对象,根据治疗方式分为内固定组(掌侧接骨板内固定治疗,n=30)和外固定组(手法复位石膏外固定治疗,n=38),记录2组患者治疗用时、并发症发生情况,比较2组患者患肢握力恢复、Gartland-Werlry评分、腕关节掌曲和背伸活动度(range of motion,ROM)、骨折愈合、治疗优良率及关节度指标(桡骨短缩、掌倾角、尺偏角)。结果内固定组手术用时长于外固定组,差异有统计学意义(P<0.05);2组并发症总发生率比较,差异无统计学意义(P>0.05);术后3个月,2组握力恢复、腕关节ROM较术后1个月均升高,Gartland-Werlry评分较术后1个月降低,且术后1、3个月,内固定组握力恢复、腕关节ROM均高于外固定组,Gartland-Werlry评分低于外固定组,差异有统计学意义(P<0.05);术后6个月,2组患者握力恢复、Gartland-Werlry评分及优良率、腕关节ROM比较,差异无统计学意义(P>0.05);内固定组骨折愈合时间、桡骨短缩短于或低于外固定组,掌倾角、尺偏角高于外固定组,差异有统计学意义(P<0.05)。结论两种手术方式均可改善桡骨远端骨折患者腕关节功能及活动度,且并发症较少,手法复位石膏外固定治疗用时较短,掌侧接骨板内固定骨折复位情况较好。Objective To explore the effect of internal fixation and external fixation for distal radius fractures on functional recovery and mobility of the wrist joint.Methods Sixty-eight patients with distal radius fractures were selected for the study and were divided into the internal fixation group(internal fixation with a palmar splint,n=30)and external fixation group(external fixation with a manipulated plaster,n=38)according to the treatment methods.The treatment time and complications of the two groups were recorded,and the recovery of grip strength,Gartland-Werlry score,range of motion(ROM),fracture healing and treatment improvement rate,and joint degree index(radial shortening,palmar tilt angle,ulnar deviation angle)of the affected limbs were compared between the two groups.Results The operation time of the internal fixation group was longer than that of the external fixation group,with a statistically significant difference(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).At 3 months after operation,grip strength recovery and wrist ROM increased in both groups compared to 1 month after surgery,and Gartland-Werlry score decreased compared to 1 month after operation.At 1 and 3 months after operation,the grip strength recovery and wrist ROM in the internal fixation group were higher than those in the external fixation group,and the Gartland-Werlry score was lower than that in the external fixation group,with statistically significant differences(P<0.05).At 6 months after surgery,there was no statistically significant difference in grip strength recovery,Gartland-Werlry score and excellent rate and carpal ROM between the two groups(P>0.05).The fracture healing time and radial shortening in the internal fixation group were shorter or lower than those in the external fixation group,and the palmar tilt angle and ulnar deviation angle were higher than those in the external fixation group,with statistically significant differences(P<0.05).Conclusion Both s

关 键 词：桡骨远端骨折 掌侧接骨板内固定 腕关节功能 活动度 

分 类 号：R687.3[医药卫生—骨科学]