石膏固定与外固定架固定治疗老年骨质疏松性桡骨远端关节内骨折的探讨

A comparative evaluation of results following closed reduction cast fixation versus external fixation for elderly osteoporotic intra-articular distal radius fractures

目的回顾性研究石膏固定与外固定架固定治疗老年骨质疏松性桡骨远端关节内骨折的疗效。方法对68例新鲜老年骨质疏松性桡骨远端关节内骨折进行了正、侧位X线片检查,并按照AO分级进行分级。采用以下两种方法之一进行治疗:(1)28例采用闭合复位石膏固定;(2)40例采用外固定架。平均随访1.5年。最终采用功能评分(Sarmiento)判定功能。结果石膏固定组优良率为53%;外固定架组优良率为87.5%。结论尽管手法复位石膏固定经济、方便、快速,但应用外固定架固定治疗骨质疏松性桡骨远端关节内骨折能够取得更加良好的效果。外固定架固定对于恢复腕关节功能以及防止该部位再骨折的发生有积极的作用。

Objective To study the efficacy of two methods, closed reduction plaster immobilisation and external fixation, in treatment of intra-articular fracture of the distal end of the radius. Methods Sixty-eight cases of acute intra-articular fracture of the lower end of the radius were classified according to AO classification after obtaining radiographs in antero-posterior and lateral planes. They were treated with one of the two methods： （1） closed reduction and plaster immobilisation,28 cases, （2） external fixation, 40 cases; and were followed up for an average of 1.5 yrs. Results In the final functional assessment （Sarmiento）, the results were： （1） cast plaster, 53% excellent and good, （2） external fixation, 87.5% excellent and good. Conclusion Although cast fixation is much cheaper and easier to perform, external skeletal fixation produces significantly better anatomical and functional results than closed reduction and fixation.