闭合复位夹板外固定和切开复位钢板内固定治疗不稳定型桡骨远端骨折疗效分析.docVIP

闭合复位夹板外固定和切开复位钢板内固定治疗不稳定型桡骨远端骨折疗效分析 　　【摘要】 目的：比较闭合复位夹板外固定与切开复位钢板内固定治疗不稳定型桡骨远端骨折的临床疗效。方法：选取本院自2013年7月-2015年7月收治的92例不稳定型桡骨远端骨折患者，50例行闭合复位夹板外固定治疗为闭合复位组，42例行切开复位桡骨远端掌侧钢板内固定术为切开复位组。结果：92例患者均获得随访，随访时间6～12个月，平均10个月。闭合复位组优、良、可、差分别为20、21、6、3例，优良率82.0%；切开复位组优、良、可、差分别为18、19、4、1例，优良率88.1%，两组优良率比较差异无统计学意义（ 字2=0.92，P0.05）。两组患者6周时影像学测量及8周时腕部功能情况比较，切开复位组优于闭合复位组（P0.05）。结论：闭合复位夹板外固定对于不稳定型桡骨远端骨折的固定不如内固定精确，桡骨茎突长度、掌倾角、尺倾角复位后存在一定的丢失。 　　【关键词】 桡骨远端骨折； 闭合复位； 切开复位； 夹板； 钢板 　　【Abstract】 Objective：To compare the clinical effect of closed reduction with splint external fixation and open plate internal fixation for unstable distal radius fractures.Method：92 patients with unstable type of the distal radius fractures were selected in our hospital from July 2013 to July 2015，50 cases were treated with closed reduction and splint external fixation as closed reduction group，42 cases were treated with open reduction and internal fixation of distal radius plate as open reduction group.Result：92 patients were followed up for 6 to 12 months，average 10 months.In closed reduction group，20 cases were excellent，21 cases were good，6 cases were reluctant，3 cases were poor，the good rate was 82.0%.In open reduction group，18 cases were excellent，19 cases were good，4 cases were reluctant，1 case was poor，the good rate was 88.1%.Compared two groups，the difference were，no statistically significant （ 字2=0.92，P0.05）.At 6 weeks imaging measurement and 8 weeks wrist function in open reduction group were better than closed reduction group（P0.05）.Conclusion：Closed reduction and splint external fixation for unstable distal radius fracture fixation is not as accurate as open reduction internal fixation，the radial styloid process length，palmar tilt and ulnar inclination have some certain lack. 　　【Key words】 Distal radius fracture； Closed reduction； Open reduction； Splint； Steel plate 　　First-author’s address：Huizhou Huakang Gushang Hospital，Huizhou 516007，China 　　doi：10.3969/j.issn.1674-4985.2016.34.031 　　?锕窃抖斯钦凼侵歌愎窃抖斯