桡骨远端不稳定性关节内骨折治疗方法的比较

Treatment method study for unstable intra-articular fractures of distal radius

目的比较外固定支架与T型钢板内固定治疗桡骨远端不稳定性关节内骨折的临床效果。方法将2007年8月~2010年1月连续48例桡骨远端不稳定性关节内骨折﹙FrykmanⅦ型、Ⅷ型﹚随机分成2组,其中外固定架组23例,男性9例,女性14例,平均年龄48.7岁﹙21~72岁﹚,右侧12例,左侧11例,按Frykman分类Ⅶ型12例,Ⅷ型11例。钢板内固定组25例,男性11例,女性14例,平均年龄50.2岁﹙20~74岁﹚,右侧12例,左侧13例,按Frykman分类Ⅶ型11例,Ⅷ型14例。分别采用闭合复位外固定架固定和切开复位T型钢板内固定治疗,Dinest标准行疗效评估。结果所有患者获得随访,随访时间12~23个月,平均16个月,X线片示所有骨折均已愈合,术后1年后复位质量和疗效2组无显著性差异﹙〉0.05﹚。结论闭合复位外固定支架固定和切开复位T型钢板内固定2种方法治疗桡骨远端不稳定性关节内骨折,均可获得较满意的疗效,应根据患者具体情况选择最佳的治疗方法。

Objective To Compare the clinic therapeutic outcomes of T plate osteosynthesis and external fixation devise for unstable distal radius joint bone fracture s.Method From August 2007 to January 2010 continuously in 48 patients unstable distal radius joint bone fracture ﹙Frykman ⅦⅧ﹚ Divides into 2 groups randomly,in external fixation group 23 patients,the male 9 cases,the female 14 cases,average age 48.7 years old ﹙21~72 years old﹚,right side12 cases,left side 11 cases,according to Frykman classificationⅦ12 cases,Ⅷ11 cases.In T plate osteosynthesis group 25 patients,male11 cases,female 14 cases,average age 50.2 years old,﹙20~74 year old﹚,right side 12 cases,left side 13 cases,according to Frykman classificationⅦ11 examples,Ⅷ14 examples.All patients were treated either with open reduction and T plate internal fixation in T plate osteosynthesis group or indirect reduction and external fixation in external fixation group.Appraises the Dinest standard good curative effect.Results All patients obtain the revisit,the revisit time 12 ~23 months,the average 16 months,X ray shows all bone fractures to heal,after the technique latter 1 year repositions the quality and the curative effect two groups of non-significance difference ﹙ 0.05﹚.Conclusion Indirect reduction and external fixation or open reduction and T plate internal fixation 2 method treatment unstable distal radius joint bone fracture,may obtain the satisfactory curative effect,because acts according to the patient special details choice best method of treatment