外固定支架与内固定治疗桡骨远端骨折的临床疗效比较

Observation on the Clinical Effect of External Fixation and Internal Fixation of Distal Radius Fractures

目的比较外固定支架与内固定治疗桡骨远端骨折的临床效果。方法选择2012年8月至2014年3月于武汉科技大学附属汉阳医院就诊的临床诊断为桡骨远端骨折的患者86例,采用随机数字表法分为外固定支架治疗组和内固定治疗组,各43例。外固定支架治疗组采用外固定支架进行治疗,内固定治疗组采用内固定进行治疗,对两种手术方式临床愈合时间及临床疗效进行比较,所有患者术后3个月进行随访,比较两组患者腕关节活动度情况。结果内固定治疗组腕关节背伸、旋后、桡偏及尺偏的角度均大于外固定支架治疗组[(41.2±3.9)°比(39.1±3.6)°,(72.5±3.5)°比(69.4±3.1)°,(14.6±2.3)°比(13.4±2.0)°,(26.4±3.1)°比(24.8±3.5)°],差异有统计学意义(P<0.05或P<0.01);内固定组的优良率为83.7%(36/43),高于外固定支架治疗组的55.8%(24/43),两组临床疗效比较差异有统计学意义(P<0.01)。结论内固定治疗桡骨远端骨折的临床疗效优于外固定支架治疗的效果,腕关节旋后及桡偏的程度大于外固定,且两组的骨折中愈合时间接近。

Objective To compare the clinical effect of external fixation and internal fixation in treat- ment of distal radius fractures. Methods Total of 86 patients diagnosed with distal radius fractures in Han- yang Hospital Affiliated to Wuhan University of Science and Technology from Aug. 2012 to Mar. 2014, and they were divided into external fixation treatment group and internal fixation treatment group according to random number table method, 43 cases each. The external fixation treatment group received external fixation treatment, and the internal fixation treatment group received internal fixation treatment. The clinical healing time and clinical effect were compared ,and and 3 months follow-up was done to compared the wrist movement of the two groups. Results The wrist dorsiflexion, supination angle and ulnar deviation, radial deviation in the internal fixation treatment group were greater than the external fixation treatment group [ （41.2±3.9 ）% vs （39.1±3.6）%,（72.5±3.5）% vs （69.4±3.1）%,（14.6±2.3）% vs （13.4±2.0）%,（26.4±3.1% vs （24. 8±3.5 ）%] , with statistically significant differences between the two groups （ P 〈 0. 05 or P 〈 0.01 ） ; the excellent rate in the external fixation group was 55.8% （ 24/43 ）, in the internal fixation group was 83.7 % （36/43）, the difference was statistically significant （ P 〈 0. 01 ）. Conclusion The clinical effect of internal fixation for the treatment of the distal radical fracture is better than external fixation ,wrist supination and radial deviation is greater than external fixation, and the median fracture healing time of the two groups is similar.