老年性桡骨远端骨折手术与非手术治疗的疗效比较

目的通过回顾性研究比较老年性桡骨远端不稳定骨折手术和非手术两种方法的治疗效果。方法随访92例年龄大于65岁的桡骨远端不稳定骨折的患者,所有病例均先行手法复位石膏外固定,对于复位不满意的再行手术治疗,随访2周、6周、3月、6月、12月,比较影像学表现及功能恢复情况。结果 50例非手术治疗,42例手术治疗。在六个月时,手术组的腕关节活动度优于非手术组,而一年时,两组活动度没有明显差异。影像学表现手术组明显优于非手术组。结论非手术治疗在一定程度上影响腕关节的活动度,而一年后对关节功能的恢复无明显影响。

Objective The purpose of this retrospective review was to compare outcomes for elderly patients with a displaced distal radiaI fracture who were treated with or without surgical intervention.Methods This case.control study examined ninety.two patients over the age of sixty.five who were treated with or without surgery for a displaced distal radial fracture.Baseline radiographs and functional scores were obtained prior to treatment.Follow.up was conducted at two,six,twelve,twenty.four,and fifty.two weeks.Results Fifty patients were treated nonoperatively,and forty—two patients were treated operatively.At twenty—four weeks,patients who underwent surgery had better wrist extension（p=O.04）than those who had not had surgery.At one year,this difference was not seen.Radiographic outcome was superior for the patients in the operative group at each follow.up interval.Conclusion Our findings suggest that minor limitations in the range of wrist motion.as seen with nonoperative care.do not seem to：mit functional recovery at one year.