Colles骨折不同外固定方法疗效分析

Effect of various external fixation for the treatment of Colles fracture

目的:观察Colles骨折不同外固定方法腕关节功能恢复和并发症情况。方法:回顾性分析1998年3月至2006年10月采用塑形小夹板腕轻度背伸位或中立位固定(A组)、塑形小夹板腕掌屈位固定(B组)、石膏腕轻度背伸位或中立位固定(C组)3种不同外固定方法治疗Colles骨折275例。其中A组95例,男61例,女34例,平均年龄(26.2±0.4)岁;B组90例,男61例,女29例,年龄(24.0±1.5)岁;C组90例,男65例,女25例,年龄(25.0±2.1)岁。按Frykaman分型:A组Ⅰ型25例,Ⅱ型31例,Ⅲ型20例,Ⅳ型11例,Ⅴ型3例,Ⅵ型2例,Ⅶ型2例,Ⅷ型1例;B组Ⅰ型22例,Ⅱ型30例,Ⅲ型17例,Ⅳ型9例,Ⅴ型4例,Ⅵ型4例,Ⅶ型2例,Ⅷ型2例;C组Ⅰ型24例,Ⅱ型30例,Ⅲ型18例,Ⅳ型9例,Ⅴ型4例,Ⅵ型3例,Ⅶ型1例,Ⅷ型1例。三组年龄、性别及骨折类型情况比较差异无统计学意义。对三组治疗后腕关节功能恢复及并发症发生情况进行比较并进行统计分析。结果:随访6～18个月,A组腕关节功能恢复和并发症发生率与B、C组比较,差异有统计学意义(P<0.05)。结论:塑形小夹板腕轻度背伸位或中立位固定治疗Colles骨折有利于腕关节功能的恢复,且并发症发生率低。

Objective ：To observe restoration of the wrist function and complications of Colles fracture treated with different kinds of external fixation. Methords：Two hundreds and seventy-five patients with Colles fracture during March 1998 to Oct 2006 which were fixed with three kinds of external fixation were analyzed retrospectively. Group A：there were 95 patients, 61 male,34 female ,with an average age of （26.2±0.4） years,fixed by the small moulding plywood on the wrist in mild dorso-extend or neutral position;Group B：90 patients, 61 male, 29 female, with an average age of （24.0±1.5）years, fixed by the small moulding plywood on the wrist in mild palmar flexion ;Group C ：90 patients ,65 male ,25 female ,with an average age of （25.0±2.1 ） years, fixed by plaster on the wrist in mild dorso-extend or neutral position. According to the Frykaman typing, number of type I to Ⅷ in group A was 25,31,20,11,3,2,2,1 in turn,type I to Ⅷ in group B was 22,30,17,9,4,4,2,2 in turn;type I to Ⅷ in group C was 24,30,18,9,4,3,1,1 in turn. Comparing the age,sex and the type of fracture,there were no statistical significant differences among three groups. After 6 to 18 months following-up survey, the restoration of the wrist and complication incidence were statistically analyzed. Results ：To compare the restoration of the wrist joint and complication incidence after various fixation, there were significant differences between group A and B and C （P〈0.05）in statistics. Conclusion：The treatment of the Colles fracture by the small moulding plywood fixation on the wrist in mild dorso-extend or neutral position is benefit to restore the wrist joint function and has fewer complications..