小切口撬拨复位外固定支架与切开复位钢板内固定术治疗C3型桡骨远端骨折患者的效果比较  

Comparison of effects of small incision reduction by leverage and external fixator and open reduction and plate internal fixation in treatment of patients with type C3 distal radius fractures

作　　者：毕楷 朱书朝 BI Kai;ZHU Shuchao(Department of Upper Limb Trauma of Nanyang Hospital of Traditional Chinese Medicine,Nanyang 473000 Henan,China)

机构地区：[1]南阳市中医院上肢创伤科,河南南阳473000

出　　处：《中国民康医学》2024年第5期150-152,163,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较小切口撬拨复位外固定支架与切开复位钢板内固定术治疗C3型桡骨远端骨折患者的效果。方法:回顾性分析2022年1月至2023年10月该院收治的80例桡骨远端C3型骨折患者的临床资料,根据手术方法不同将其分为对照组与观察组各40例。对照组采用切开复位钢板内固定术治疗,观察组采用小切口撬拨复位外固定支架治疗。比较两组临床疗效,手术相关指标,术前、术后3个月时骨折复位情况(桡骨高度、掌倾角及关节面台阶高度),术后即刻、术后3个月时腕关节活动度(背伸、掌屈、桡偏及尺偏角度),以及并发症发生率。结果:观察组优良率为95.00%(38/40),高于对照组的77.50%(31/40),差异有统计学意义(P<0.05);观察组手术时间、骨折愈合时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后3个月时,观察组桡骨高度、掌倾角及腕关节背伸、掌屈、桡偏、尺偏角度均大于对照组,关节面台阶小于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:小切口撬拨复位外固定支架治疗桡骨远端C3型骨折患者疗效优良率高于切开复位钢板内固定术,而且能够缩短手术时间、骨折愈合时间、住院时间,减少术中出血量,提高骨折复位效果和腕关节活动度。Objective:To compare effects of small incision reduction by leverage and external fixator and open reduction and plate internal fixation in treatment of patients with type C3 distal radius fractures.Methods:The clinical data of 80 patients with type C3 distal radius fractures admitted to this hospital from January 2022 to October 2023 were retrospectively analyzed.According to different surgical methods,they were divided into control group and observation group,40 cases in each group.The control group was treated with open reduction and plate internal fixation,while the observation group was treated with small incision reduction by leverage and external fixator.The clinical efficacy,the operation related indexes levels,the fracture reduction(radial height,palmar tilt angle and articular surface step height)before and 3 months after the surgery,the wrist range of motion(dorsal extension,palmar flexion,radial deviation and ulnar deviation angle)immediately and 3 months after the surgery,and the incidence of complications were compared between the two groups.Results:The excellent and good rate of the observation group was 95.00%(38/40),which was higher than 77.50%(31/40)of the control group,and the difference was statistically significant(P<0.05).The operation time,the fracture healing time and the hospitalization time of the observation group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,and the differences were statistically significant(P<0.05).Three months after the surgery,the radial height,palmar inclination,wrist dorsiflexion,palmar flexion,radial deviation and ulnar deviation levels of the observation group were higher than those of the control group,the articular surface steps were smaller than those of the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:The excellent and good rate of small incisi

关 键 词：桡骨远端骨折 C3型骨折 粉碎性骨折 小切口撬拨复位 外固定支架 切开复位内固定术 

分 类 号：R687.3[医药卫生—骨科学]