| 单臂外固定架联合经皮穿针固定治疗老年C1型桡骨远端骨折的近期临床疗效 |
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投稿时间：2024-09-23
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| 作者 | Author | 单位 | Address | E-Mail |
| 沈润斌 |
SHEN Run-bin |
河北省沧州中西医结合医院微创骨伤科, 河北 沧州 061000
河北省中西医结合医学3D打印技术创新中心, 河北 沧州 061000 |
Minimally Invasive Orthopedics Department, Cangzhou Integrated Traditional Chinese and Western Medicine Hospital, Cangzhou 061000, Hebei, China
Hebei Province Integrated Traditional Chinese and Western Medicine 3D Printing Technology Innovation Center, Cangzhou 061000, Hebei, China |
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| 李国梁 |
LI Guo-liang |
河北省沧州中西医结合医院微创骨伤科, 河北 沧州 061000
河北省中西医结合医学3D打印技术创新中心, 河北 沧州 061000 |
Minimally Invasive Orthopedics Department, Cangzhou Integrated Traditional Chinese and Western Medicine Hospital, Cangzhou 061000, Hebei, China
Hebei Province Integrated Traditional Chinese and Western Medicine 3D Printing Technology Innovation Center, Cangzhou 061000, Hebei, China |
shenrunbin@163.com |
| 刘小平 |
LIU Xiao-ping |
华北理工大学, 河北 唐山 063000 |
North China University of Science and Technology, Tangshan 063000, Hebei, China |
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| 陈康 |
CHEN Kang |
河北省沧州中西医结合医院微创骨伤科, 河北 沧州 061000
河北省中西医结合医学3D打印技术创新中心, 河北 沧州 061000 |
Minimally Invasive Orthopedics Department, Cangzhou Integrated Traditional Chinese and Western Medicine Hospital, Cangzhou 061000, Hebei, China
Hebei Province Integrated Traditional Chinese and Western Medicine 3D Printing Technology Innovation Center, Cangzhou 061000, Hebei, China |
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| 韩广普 |
HAN Guang-pu |
河北省中西医结合医学3D打印技术创新中心, 河北 沧州 061000 |
Hebei Province Integrated Traditional Chinese and Western Medicine 3D Printing Technology Innovation Center, Cangzhou 061000, Hebei, China |
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| 赵建勇 |
ZHAO Jian-yong |
河北省中西医结合医学3D打印技术创新中心, 河北 沧州 061000 |
Hebei Province Integrated Traditional Chinese and Western Medicine 3D Printing Technology Innovation Center, Cangzhou 061000, Hebei, China |
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| 期刊信息：《中国骨伤》2025年，第38卷，第1期，第25-30页 |
| DOI：10.12200/j.issn.1003-0034.20240505 |
| 基金项目:2024年度河北省医学科学研究课题计划(编号:20240655) |
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中文摘要:
目的: 探讨闭合复位单臂外固定架联合经皮穿针固定治疗老年C1型桡骨远端骨折的近期临床疗效。
方法: 自2022年12月至2023年12月治疗老年C1型桡骨远端骨折病例60例，其中男9例，女51例;年龄65~84(72.69±8.14)岁;左侧18例，右侧42例;摔伤55例，车祸伤5例。根据手术方法不同分为对照组和观察组，每组30例。对照组采用手法复位单臂外固定架固定，男4例，女26例;年龄(72.54±8.67)岁;身体质量指数(body mass index，BMI)为(20.61±2.17) kg·m-2;左侧10例，右侧20例;摔伤27例，车祸伤3例。观察组采用手法复位单臂外固定架联合经皮穿针固定，男5例，女25例;年龄(72.76±7.23)岁;BMI(20.82±2.03) kg·m-2;左侧8例，右侧22例;摔伤28例，车祸伤2例。记录并比较两组术前及术后2 d、12周桡骨高度、尺偏角、掌倾角变化及腕关节患者自行评分量表(patient-rated wrist evaluation，PRWE)，比较两组测量结果。
结果: 两组病例均顺利完成手术，无严重并发症。60例均获得随访，时间12~20(14.50±2.78)周。两组术后2 d及12周同术前比较桡骨高度、掌倾角、尺偏角差异均有统计学意义(P<0.05);在术后2 d时两组间桡骨高度、掌倾角、尺偏角差异均无统计学意义(P>0.05);而在术后12周时两组间桡骨高度、掌倾角、尺偏角比较差异均有统计学意义(P<0.05)。两组术后2 d及12周PRWE评分与术前比较，差异均有统计学意义(P<0.05);在术后2 d时两组间PRWE评分比较，差异无统计学意义(P>0.05);而在术后12周时两组间PRWE评分比较，差异有统计学意义(P<0.05)。
结论: 闭合复位单臂外固定架联合经皮穿针固定可提高C1型桡骨远端骨折固定的可靠性，阶段性拆除固定装置更有利于腕关节功能恢复。 |
| 【关键词】闭合复位 经皮穿针 单臂外固定架 老年桡骨远端骨折 |
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| Short-term clinical efficacy of unilateral external fixator combined with percutaneous Kirschner wire fixation in the treatment of type C1 distal radius fractures in elderly patients |
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ABSTRACT
Obiective To investigate the short-term clinical effect of closed reduction single arm external fixator combined with percutaneous needle fixation in the treatment of C1 distal radius fracture in elderly patients.
Methods Between December 2022 and December 2023,a total of 60 elderly patients diagnosed with type C1 distal radius fractures were treated,comprising 9 males and 51 females. The age ranged from 65 to 84 years old,with an average of (72.69±8.14) years old. Among them,there were 18 cases on the left side and 42 cases on the right side. There were 55 cases of falling injury and 5 cases of traffic accident injury. According to the different surgical methods,the patients were divided into observation group and control group,with 30 cases in each group. The control group underwent manual reduction and unilateral external fixator fixation,consisting of 4 males and 26 females. The mean age was (72.54±8.67) years old. The body mass index (BMI) was (20.61±2.17) kg·m-2. There were 10 cases on the left side and 20 cases on the right side. Among them,there were 27 cases of falling injury and 3 cases of traffic accident injury. The observation group was treated with manual reduction and unilateral external fixator combined with percutaneous Kirschner wire fixation,including 5 males and 25 females. The mean age was (72.76±7.23) years old. BMI (20.82±2.03) kg·m-2. The left side was involved in 8 cases and the right side in 22 cases. There were 28 cases of falling injury and 2 cases of traffic accident injury. The changes in radial height,ulnar declination,palmar inclination angle parameters and patient-rated wrist evaluation (PRWE) were assessed on X-ray films before surgery,2 days after surgery,and 12 weeks after surgery between the two groups.
Results All surgical procedures were successfully completed in both groups without any significant complications. All patients were followed up for a duration from 12 to 20 weeks with an average of(14.50±2.78) weeks. The two groups exhibited significant differences in radial height,palmar inclination angle,and ulnar deviation angle at 2 days and 12 weeks post-operation (P<0.05). However,there was no statistically significant difference observed in radial height,palmar inclination,and ulnar deviation between the two groups at 2 days after the operation (P>0.05). There were significant differences in radial height,palmar inclination angle,and ulnar deviation between the two groups at 12 weeks after operation (P<0.05). At 2 days and 12 weeks after the operation,there were significant differences in PRWE scores of the two groups compared with preoperative scores(P<0.05). At 2 days after the operation,there was no significant difference in PRWE score between the two groups (P>0.05). The PRWE score showed a significant difference between the two groups at 12 weeks post-operation(P<0.05).
Conclusion The combination of closed reduction and unilateral external fixator,along with percutaneous pin fixation provides move stable fixation for type C1 distal radius fractures. Gradual removal of external fixator further facilitatse the recovery of wrist joint function. |
| KEY WORDS Closed reduction Percutaneous Kirschner wire Unilateral external fixator Distal radius fracture in the elderly |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 沈润斌,李国梁,刘小平,陈康,韩广普,赵建勇.单臂外固定架联合经皮穿针固定治疗老年C1型桡骨远端骨折的近期临床疗效[J].中国骨伤,2025,38(1):25~30 |
| 英文格式: | SHEN Run-bin,LI Guo-liang,LIU Xiao-ping,CHEN Kang,HAN Guang-pu,ZHAO Jian-yong.Short-term clinical efficacy of unilateral external fixator combined with percutaneous Kirschner wire fixation in the treatment of type C1 distal radius fractures in elderly patients[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(1):25~30 |
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