T形锁定钢板内固定与外固定支架治疗背侧Barton骨折的病例对照研究
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作者Author单位AddressE-Mail
陈焕庆 CHEN Huan-qing 平阳县人民医院骨科, 浙江 温州 325400 Department of Orthopaedics, People's Hospital of Pingyang, Wenzhou 325400, Zhejiang, China pygkchq@163.com 
温喜乐 WEN Xi-le 平阳县人民医院骨科, 浙江 温州 325400 Department of Orthopaedics, People's Hospital of Pingyang, Wenzhou 325400, Zhejiang, China  
李阳明 LI Yang-ming 平阳县人民医院骨科, 浙江 温州 325400 Department of Orthopaedics, People's Hospital of Pingyang, Wenzhou 325400, Zhejiang, China  
温从游 WEN Cong-you 平阳县人民医院骨科, 浙江 温州 325400 Department of Orthopaedics, People's Hospital of Pingyang, Wenzhou 325400, Zhejiang, China  
期刊信息:《中国骨伤》2015年,第28卷,第6期,第517-520页
DOI:10.3969/j.issn.1003-0034.2015.06.008
基金项目:
中文摘要:

目的:比较T形锁定钢板内固定和外固定支架治疗背侧Barton骨折的临床疗效, 探讨内固定方法选择的策略。

方法:选取2008年1月至2013年1月治疗的100例背侧Barton骨折患者, 分为研究组和对照组。研究组男30例, 女20例;平均(33.8±3.6)岁;B型30例, C型20例;采用T形锁定钢板内固定治疗。对照组男32例, 女18例;平均(32.9±3.4)岁;B型29例, C型21例;采用外固定支架治疗。测量并比较两组患者术后3个月掌倾角、尺偏角和桡骨高度, 并采用Mehara功能评价标准进行疗效评估。观察两组患者临床治愈时间、术后并发症发生情况及关节活动、功能评分情况。

结果:研究组掌倾角(11.9±2.7)°, 尺偏角(20.8±2.9)°, 桡骨高度(10.9±1.8) mm;对照组掌倾角(9.1±1.6)°, 尺偏角(17.1±2.9)°, 桡骨高度(8.1±1.5) mm;研究组均优于对照组。研究组临床治愈时间(12.0±2.3)周, 少于对照组(18.0±4.1)周;研究组术后并发症发生率低于对照组。根据Mehara评价标准, 研究组优20例, 良25例, 可3例, 差2例;对照组优16例, 良14例, 可10例, 差10例, 研究组疗效优于对照组。

结论:T形锁定钢板内固定配合术后功能锻炼治疗背侧Barton骨折符合生物力学要求, 具有固定稳定牢靠、愈合快、术后并发症发生率低、功能恢复良好的优点。
【关键词】桡骨骨折  骨折固定术, 内  外固定器  病例对照研究
 
Case-control study on T-shaped locking internal fixation and external fixation for the treatment of dorsal Barton's fracture
ABSTRACT  

Objective:To compare clinical effect of T-shaped locking internal fixation and external fixation in treating dorsal Barton's fracture, and investigate selective strategy of internal fixation.

Methods:From January 2008 to January 2013, 100 patients with dorsal Barton's fracture were randomly divided into two groups. In treatment group, there were 30 males and 20 females with an average age of (33.8±3.6) years old;30 cases were type B, 20 cases were type C;and treated with T-shaped locking internal fixation. In control group, there were 32 male and 18 females with an average age of (32.9±3.4) years old; 29 cases were type B, 21 cases were type C;and treated with external fixation. Volar tilt, ulnar deviation and radial height at 3 months after operation were detected and compared between two groups. Mechara functional evaluation were used to evaluate postoperative clinical effects. Clinical cure time, postoperative complications, joint mobility and function score were recorded and compared between two groups.

Results:In treatment group, volar tilt was(11.9±2.7)°, ulnar deviation was (20.8±2.9)°, and radial height was (10.9±1.8) mm; while volar tilt was (9.1±1.6)°, ulnar deviation was (17.1±2.9)°, and radial height was (8.1±1.5) mm in control group. Treatment group was better than control group in volar tilt, ulnar deviation and radial height. Clinical cure time in treatment group was(12.0±2.3) weeks, shorter than control group(18.0±4.1) weeks. The incidence of complications in treatment group was lower than control group. According to Mehara functional evaluation, 20 cases got excellent results, 25 good, 3 moderate and 2 poor in treatment group; 16 cases got excellent results, 14 good, 10 moderate and 10 poor in control group. Treatment group was better than control group in clinical effects.

Conclusion:T-shaped locking internal fixation with postoperative functional exercise for the treatment of dorsal Barton's fracture fits for biomechanics demands, and has advantages of stable fixation, rapid recovery, less complications and good functional recovery, it has better clinical effects.
KEY WORDS  Radius fractures  Fracture fixation,internal  External fixators  Case-control studies
 
引用本文,请按以下格式著录参考文献:
中文格式:陈焕庆,温喜乐,李阳明,温从游.T形锁定钢板内固定与外固定支架治疗背侧Barton骨折的病例对照研究[J].中国骨伤,2015,28(6):517~520
英文格式:CHEN Huan-qing,WEN Xi-le,LI Yang-ming,WEN Cong-you.Case-control study on T-shaped locking internal fixation and external fixation for the treatment of dorsal Barton's fracture[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(6):517~520
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