外固定架联合克氏针固定术与切开复位掌侧锁定钢板固定术对桡骨远端完全关节内骨折的治疗效果比较  

Curative Effect Comparison of External Fixator Combined with Kirschner Wire Fixation and Open Reduction Palmar Locking Plate Fixation for Complete Intra-articular Distal Radius Fractures

作　　者：戴绍宗 DAI Shaozong(Luoding City Traditional Chinese Medicine Hospital,Luoding,Guangdong 527200)

机构地区：[1]罗定市中医院,广东罗定527200

出　　处：《智慧健康》2024年第31期59-62,共4页Smart Healthcare

摘　　要：目的 比较外固定架联合克氏针固定术与切开复位掌侧锁定钢板固定术治疗桡骨远端完全关节内骨折的效果。方法 选择2021年3月—2023年7月在本院骨科接受手术治疗的64例桡骨远端完全关节内骨折患者,随机分为外固定组和内固定组,每组32例。其中,外固定组行外固定架联合克氏针固定术,内固定组行切开复位掌侧锁定钢板固定术,比较两组手术指标、伤愈进度、术前及末次随访的影像学结果、末次随访的腕关节活动度和腕关节功能、术后并发症情况。结果 外固定组手术时间、术中出血量、住院时间和骨折愈合时间少于内固定组(P<0.05)。末次随访外固定组掌倾角小于内固定组(P<0.05),两组尺偏角和桡骨高度对比,差异无统计学意义(P>0.05)。末次随访外固定组掌屈小于内固定组(P<0.05);两组背伸、尺偏、桡偏、旋前、旋后对比,差异无统计学意义(P>0.05)。两组腕关节功能及术后并发症发生率对比,差异无统计学意义(P>0.05)。结论 应用外固定架结合克氏针进行治疗,其创伤较小,恢复时间较短。而采用切开复位掌侧锁定钢板固定术,虽然在复位效果上略胜一筹,但在腕关节功能恢复和术后并发症方面,并未见显著差异。Objective To compare effect of external fixator combined with Kirschner wire fixation and open reduction palmar locking plate fixation for complete intra-articular distal radius fractures.Methods The paper chose 64 patients with complete intra-articular distal radius fractures with surgical treatment in our orthopedic department from March 2021 to July 2023,and divided them into the external fixation group and the internal fixation group randomly,with 32 cases in each group.The external fixation group was treated with external fixator combined with Kirschner wire fixation,while the internal fixation group with open reduction and palmar locking plate fixation.Surgical indicators,injury recovery progress,preoperative and last follow-up imaging results,wrist joint range of motion and wrist joint function,and postoperative complications were compared between two groups.Results Surgical time,intraoperative bleeding,length of stay,and fracture healing time of the external fixation group was less than the internal fixation group(P<0.05).At the last follow-up,palmar inclination angle of the external fixation group was smaller than the internal fixation group(P<0.05),there was no statistically significant difference in ulnar deviation angle and radial height between two groups(P>0.05).During the last follow-up,palmar flexion of the external fixation group was smaller than the internal fixation group(P<0.05),there was no statistical difference between two groups in dorsiflexion,ulnar deviation,radial deviation,pronation and supination(P>0.05).There was no statistically significant difference in wrist joint function and incidence of postoperative complications between two groups(P>0.05).Conclusion Combination of external fixator and Kirschner wire fixation has less trauma and faster recovery,while open reduction and palmar locking plate fixation has slightly higher reduction quality,with no significant difference in wrist joint function and postoperative complications.

关 键 词：外固定架 克氏针 切开复位 掌侧入路 钢板固定 桡骨远端骨折 

分 类 号：R68[医药卫生—骨科学]