外固定支架与小夹板固定治疗桡骨远端不稳定性骨折病例对照研究

Case-control Study of Small Splint and External Fixation for Unstable Distal Radius Fractures

目的：探讨超关节外固定支架结合有限内固定在桡骨远端不稳定性骨折治疗中的作用,并与小夹板外固定治疗对比。方法：对2003年3月~2007年8月我院就诊的88例有完整随访资料的桡骨远端不稳定性骨折患者进行分析研究,其中外固定支架固定组（手术组）56例,小夹板外固定治疗组（保守组）32例,分别从主观功能评定以及影像学、腕关节活动范围和握力等客观指标方面进行评价。结果：所有病例均在3月内临床愈合,关节功能评定优良率手术组78.7%,保守组37.5%（P〈0.001）;手术组自复位后未再发生明显移位,保守组则在复位后第10天发生移位;无论是影像学表现、腕关节活动范围还是握力等客观指标比较手术组均要优于保守组。结论：外固定支架可作为治疗桡骨远端不稳定性骨折的首选,其固定牢靠,创伤小,疗效好,并发症少,值得推广。

Objective.. To evaluate the efficacy of over-articlular external fixation combined with limited internal fixation in treating unstable distal radius fractures, and compare the effect with that of small splint. Methods： Eighty-eight cases of unstable distal radius fracture diagnosed in our hospital from March 2003 to August 2007 were divided into two groups, among whom 56 cases were given external fixation and the rest 32 cases were treated by small splint fixation. Evaluations were made from the aspects of subjective functional assessment, radiographs, range of motion of the wrist, grasp force, et al. Results.. All the cases were cured within 3 months. The excellent and good rate was 78.7% for surgery group and 37. 5% for conservative group （P〈0. 001）. No redisplacement occurred in the surgery group, however, redisplacement was observed in the control group 10 days after the fixation. The data of radiographs, range of motion of the wrist and grasp force all showed better results in surgery group than in control group. Conclusion： External fixation should be the first choice for unstable distal radius fractures due to its stable fixation, miniinvasion, desirable effect and fewer complications.