| 外固定架与DVR解剖锁定板治疗C型桡骨远端骨折的疗效对比 |
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Received:August 20, 2016
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| 作者 | Author | 单位 | Unit | E-Mail |
| 章筛林 |
ZHANG Shai-lin |
上海中医药大学附属普陀医院骨科, 上海 200062 |
Department of Orthopaedics, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China |
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| 纪斌 |
JI Bin |
上海中医药大学附属普陀医院骨科, 上海 200062 |
Department of Orthopaedics, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China |
jibin1110@hotmail.com |
| 成翔宇 |
CHENG Xiang-yu |
上海中医药大学附属普陀医院骨科, 上海 200062 |
Department of Orthopaedics, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China |
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| 周强 |
ZHOU Qiang |
上海中医药大学附属普陀医院骨科, 上海 200062 |
Department of Orthopaedics, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China |
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| 石继祥 |
SHI Ji-xiang |
上海中医药大学附属普陀医院骨科, 上海 200062 |
Department of Orthopaedics, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China |
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| 庞金辉 |
PANG Jin-hui |
上海中医药大学附属普陀医院骨科, 上海 200062 |
Department of Orthopaedics, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China |
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| 期刊信息：《中国骨伤》2016年29卷，第11期，第1005-1010页 |
| DOI：10.3969/j.issn.1003-0034.2016.11.007 |
| 基金项目:上海市普陀区卫生系统自主创新项目（编号：2013PTKW015） |
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目的：比较DVR解剖锁定钢板与外固定架治疗C型桡骨远端骨折的临床效果。
方法：对2009年1月至2013年12月收治的52例C型桡骨远端骨折患者的临床资料进行回顾性分析，其中31例采用掌侧入路切开复位、DVR解剖锁定钢板内固定（钢板内固定组），男11例，女20例；年龄24~65岁，平均（47.3±10.9）岁；左侧13例，右侧18例；按桡骨远端骨折AO分型，C1型12例，C2型15例，C3型4例。21例采用闭合复位、外固定架固定（外固定架组），男8例，女13例；年龄26~69岁，平均（48.1±12.1）岁；左侧10例，右侧11例；按桡骨远端骨折AO分型，C1型7例，C2型11例，C3型3例。对两组患者的术后影像学、腕关节活动度及Gartland-Werley功能评分进行比较。
结果：术后52例患者均获得随访，钢板内固定组随访时间13~36个月，平均20.4个月；外固定架组随访时间11~33个月，平均17.1个月。钢板内固定组患者掌倾角和尺偏角均优于外固定架组（P<0.05），两组患者桡骨高度和Gartland-Werley评分比较差异无统计学意义（P>0.05）.钢板内固定组1例出现腕关节僵硬、握力下降；外固定架组发生钉道感染2例，固定松动1例，腕关节僵硬、握力下降2例。
结论：采用DVR解剖锁定钢板治疗C型桡骨远端骨折，操作简单，固定可靠，疗效优于外固定架，但DVR解剖锁定钢板内固定手术费用高，需二次手术取出内固定，临床上可根据患者具体情况选择治疗方式。 |
| [关键词]:桡骨远端骨折 骨折固定术,内 外固定器 病例对照研究 |
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| Comparison between external fixator and DVR system for the treatment of AO type C distal radial fractures |
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Abstract:
Objective: To compare the clinical effects of external fixator versus DVR system for the treatment of AO type C distal radius fractures.
Methods: The clinical data of 52 patients with type C distal radial fractures treated with external fixator or DVR system respectively from January 2009 to December 2013 were analyzed retrospectively. In DVR system group,31 patients were treated by open reduction and internal fixation with DVR system,involved 11 males and 20 females,with an average age of(47.3±10.9) years ranging from 24 to 65 years;according to AO/ASIF classification,12 cases were type C1,15 cases were type C2,4 cases were type C3. In external fixator group,21 patients were treated by closed reduction and cross wrist external fixation, involved 8 males and 13 females,with an average age of (48.1±12.1) years ranging from 26 to 69 years; according to AO/ASIF classification,7 cases were type C1,11 cases were type C2,3 cases were type C3. The postoperative images,wrist joint functions and Gartland-Wetley scores were evaluated and compared.
Results: Thirty-one patients in DVR system group were followed up for 20.4 months(ranged from 13 to 36 months) and in external fixator group 21 patients were followed up for 17.1 months (ranged from 11 to 33 months) respectively. X-rays showed all fractures healed. The palm dip and radial inclination in the DVR system group were significantly better than in the external fixator group(P<0.05),while there was no significant difference in radial height and Gartland-Werley score(P>0.05). There was 1 case of wrist stiffness in the DVR system group;2 cases of pin tract infection,1 case of fixator loosening and 2 cases of wrist stiffness in the external fixator group.
Conclusion: Clinical outcomes of DVR system fixation for type C distal radial fractures are better than that of external fixator fixation. However,DVR system fixation costs more and requires a secondary surgery to remove the internal fixation. The choices of surgical method depend on the clinical conditions of the patients. |
| KEYWORDS:Distal 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: | 章筛林,纪斌,成翔宇,周强,石继祥,庞金辉.外固定架与DVR解剖锁定板治疗C型桡骨远端骨折的疗效对比[J].中国骨伤,2016,29(11):1005~1010 |
| 英文格式: | ZHANG Shai-lin,JI Bin,CHENG Xiang-yu,ZHOU Qiang,SHI Ji-xiang,PANG Jin-hui.Comparison between external fixator and DVR system for the treatment of AO type C distal radial fractures[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(11):1005~1010 |
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