| 内外固定治疗桡骨远端不稳定骨折的临床对照研究 |
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Received:July 06, 2011
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| 作者 | Author | 单位 | Unit | E-Mail |
| 赵勇 |
ZHAO Yong |
中国中医科学院望京医院骨科，北京 100102 |
Department of Orthopaedics, Wangjing Hospital of China Academy of Chinese Medical Science, Beijing 100102, China |
Zhaoyong423@sohu.com |
| 崔秀仁 |
CUI Xiu-ren |
北京市平谷区中医医院 |
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| 关继超 |
GUAN Ji-chao |
中国中医科学院望京医院骨科，北京 100102 |
Department of Orthopaedics, Wangjing Hospital of China Academy of Chinese Medical Science, Beijing 100102, China |
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| 张兴平 |
ZHANG Xing-ping |
中国中医科学院望京医院骨科，北京 100102 |
Department of Orthopaedics, Wangjing Hospital of China Academy of Chinese Medical Science, Beijing 100102, China |
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| 闫安 |
YAN An |
中国中医科学院望京医院骨科，北京 100102 |
Department of Orthopaedics, Wangjing Hospital of China Academy of Chinese Medical Science, Beijing 100102, China |
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| 张宽 |
ZHANG Kuan |
中国中医科学院望京医院骨科，北京 100102 |
Department of Orthopaedics, Wangjing Hospital of China Academy of Chinese Medical Science, Beijing 100102, China |
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| 桑志成 |
SANG Zhi-cheng |
中国中医科学院望京医院骨科，北京 100102 |
Department of Orthopaedics, Wangjing Hospital of China Academy of Chinese Medical Science, Beijing 100102, China |
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| 何冀川 |
HE Ji-chuan |
北京市丰盛医院 |
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| 谢澄诚 |
XIE Cheng-cheng |
中国中医科学院望京医院骨科，北京 100102 |
Department of Orthopaedics, Wangjing Hospital of China Academy of Chinese Medical Science, Beijing 100102, China |
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| 期刊信息：《中国骨伤》2011年24卷，第11期，第894-897页 |
| DOI：10.3969/j.issn.1003-0034.2011.11.003 |
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目的：探讨复位外固定器治疗桡骨远端不稳定骨折的疗效。
方法：采用配对设计，回顾性分析了2005年8月至2009年9月收治的60例桡骨远端不稳定骨折患者，其中男8例，女52例；年龄34～85岁，平均60.27岁；左侧33例，右侧27例。所有骨折为自行摔倒后手撑地所致，均为闭合性骨折。按AO分型：A3型22例，B2型4例，B3型2例，C1型20例，C2型8例，C3型4例。分别采用切开复位钢板内固定及闭合复位外固定器治疗。观察术前术后掌屈、背伸、桡偏、尺偏、旋前、旋后、握力、掌倾角、尺偏角及桡骨短缩。
结果：60例均获随访，时间12～18个月，平均15.4个月。桡骨高度：外固定组平均(4.85±2.75) mm,内固定组平均(4.29±1.53) mm;掌倾角：外固定组平均(14.66±10.77)°，内固定组平均(14.39±5.01)°；尺偏角：外固定组平均(7.90±4.70) °，内固定组平均(6.19±3.15) °。两组比较差异均无统计学意义(P>0.05).内固定组与外固定组功能比较，除旋后及桡偏外，其余指标差异无统计学意义(P≥0.05).采用Batra腕关节评分标准测定两组患者术后1年腕关节功能，外固定组Batra解剖评分平均86.27分，其中优15例，良11例，可1例，差3例；功能评分平均94.93分，均为优。内固定组Batra解剖评分平均91.27分，其中优16例，良12例，可2例；功能评分平均94.23分，均为优。
结论：复位外固定器与钢板内固定治疗桡骨远端不稳定骨折疗效相近，无明显差异。 |
| [关键词]:桡骨骨折 骨折固定术，内 外固定器 病例对照研究 |
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| A case control study on the treatment of unstable distal radius fractures with internal and external fixation |
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Abstract:
Objective: To explore the clinical effects of diaplastic external fixator on the treatment of unstable fractures of distal radius.
Methods: A clinical data of 60 patients with unstable fractures of distal radius admitted to Wangjing Hospital from August 2005 to September 2009 were retrospectively analyzed with the paired design. According to the paired design, 60 patients were equally divided into two groups (internal fixation group and external fixation group), which were respectively treated with open reduction and steel plate internal fixation(internal fixation group) or closed reduction and external fixation (external fixation group), including 8 males and 52 females, with an average age of 60. 27 years ranging from 34 to 85 years. Left side was in 33 cases and right side was in 27 cases. All fractures were closed and caused by hand supporting when falling down. According to AO classification, type A3 was in 22 cases, type B2 was in 4 cases, type B3 was in 2 cases, type C1 was in 20 cases, type C2 was in 8 cases, type C3 was in 4 cases. Palmar flexion, dorsiflexion, radial deviation, ulnar deviation, pronation, supination, grip strength, radial angle, radial length, volar tilt were observed before and after operation.
Results: All the patients were followed up from 12 to 18 months with an average of 15. 4 months. The radial length was(4. 85±2. 75) mm, volar tilt (14. 66±10. 77)°, radial angle (7. 90±4. 70)° in the external fixation group, while those were (4. 29±1. 53) mm, (14. 39±5. 01)°, (6. 19±3. 15)° in the internal fixation group, but with no statistical significance(P>0. 05). Function comparison of internal and external fixation group, P-value of every function is more than 0. 05 or equal to 0. 05, with no statistical significance except for supination and radial deviation. The functions of wrist joints were evaluated according to Batra scoring system at 1 year after operation. The average radiological scores of external fixation group was 86. 27, in which 15 cases were excellent, 11 good, 1 fair, 3 poor, while the average functional scores was 94. 93, and all the cases were excellent. The average radiological scores of internal fixation group was 91. 27, 16 cases were excellent, 12 good, 2 fair, while the average functional scores was 94. 23, in which all the cases were excellent.
Conclusion: Compared with the open reduction and steel plate fixation, the unstable fractures of distal radius treating by diaplastic external fixator can be achieved a similar result, with no statistical significance. |
| KEYWORDS:Radius fractures Fracture fixation, internal External fixators Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 赵勇,崔秀仁,关继超,张兴平,闫安,张宽,桑志成,何冀川,谢澄诚.内外固定治疗桡骨远端不稳定骨折的临床对照研究[J].中国骨伤,2011,24(11):894~897 |
| 英文格式: | ZHAO Yong,CUI Xiu-ren,GUAN Ji-chao,ZHANG Xing-ping,YAN An,ZHANG Kuan,SANG Zhi-cheng,HE Ji-chuan,XIE Cheng-cheng.A case control study on the treatment of unstable distal radius fractures with internal and external fixation[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(11):894~897 |
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