两种方法治疗桡骨远端骨折的临床疗效对比研究

THE CONTRAST STUDY OF THE CLINICAL CURATIVE EFFECT OF TREATING DISTAL RADIAL FRACTURES BY TWO METHODS

目的:改进石膏固定治疗桡骨远端骨折,观察其疗效并与夹板固定进行放射学比较。方法:100例桡骨远端骨折病人,随机分成两组。经手法复位后,治疗组50例以改进缠绕式石膏条超腕掌关节固定,对照组50例以传统夹板固定。两组定期摄片复查直至骨折临床愈合,拆除外固定后指导功能锻炼,6mo后两组病人参照Cartland-Werlley腕关节功能评分标准进行疗效评分,放射学疗效按Lidstrom分级法比较。结果:腕关节功能评分,治疗组平均4.0±2.5分,优15例,良26例,可9例,优良率为82%;对照组平均6.0±4.1分,优12例,良21例,可17例,优良率为66%。放射学评级,治疗组:Ⅰ级35例,Ⅱ级11例,Ⅲ级4例;对照组:Ⅰ级23例,Ⅱ级17例,Ⅲ级10例。结论:改进石膏固定治疗桡骨远端骨折较传统夹板为好。

Objective：To treat the distal radial fracture by improved plaster, and observe its curative effect and compare the radiology with the traditional splint. Methods： I00 patients with distal radial fracture were randomly divided into two groups. After manual reduction, 50 cases of the treatment group were fixed at supra - earpometaearpal joints by improved plaster and trapezoid pad, the other 50 cases of control group were treated with the traditional splint. Both groups were regularly taken X - ray cheek and changed dressings to obtain the clinical cicatrization. Patients were guided to do functional exercise after piaster were taken off. Six months later all patients were evaluated the curative and radiologic effect according to gartland -Werlley wrist score and Lidstrom grade respectively. Results： Accordiing to wrist score,there were 15 cases on excellent, 26 cases on fine and 9 cases on normal in treatment group, which average score was 4. 0±2. 5 and the percentage of wrist functional fitness was 82%. There were 12 cases on excellent, 21 cases on fine and 17 cases on normal in control group,which average score was 6. 0±4. 1, and the percentage of wrist functional fitness was 66 %. According to radiology grade, there were 35 cases on the first grade, 11 cases on the second grade and 4 cases on the third grade in treatment group,there were 23 cases on the first grade, 17 cases on the second grade and 10 cases on the third grade in control group. Conclusion： The outcome of improved plaster was better than that of traditional splint on the function and radiology for treating the distal radial fracture.