切开复位与闭合复位治疗老年桡骨远端骨折疗效比较

Clinical research of open reduction and closed reduction in the treatment of elderly distal radial fractures

目的探讨切开复位与闭合复位治疗老年桡骨远端骨折的临床效果。方法以随机数字表法将66例老年桡骨远端骨折患者分为切开复位组(33例)与闭合复位组(33例),切开复位组予切开复位内固定治疗,闭合复位组予闭合复位石膏(夹板)外固定治疗。观察两组患者的骨折愈合情况、腕关节恢复与功能情况。结果切开复位组和闭合复位组骨折愈合时间分别为(11.2±2.3)周和(10.8±2.1)周,两组比较差异无统计学意义(P>0.05)。切开复位组患者的掌倾角、尺偏角、桡骨恢复情况以及腕关节功能评价情况均优于闭合复位组。结论对于老年桡骨远端骨折,采用切开复位内固定治疗,能可靠恢复桡骨长度,可早期功能锻炼,缩短康复时间,获得理想的复位质量和疗效。

Objective To study the clinical effect of the open reduction and closed reduction in the treat- ment of elderly distal radial fractures. Methods According to random number table 66 elderly patients with distal ra- dial fractures were randomly divided into open reduction group and closed reduction groups, with 30 patients in eath group, and were treated by surgery or manipulation therapy respectively. The fracture healing and function recovery of wrist joint were observed. Results In open reduction group and closed reduction group the fracture healing time were （ 11.2 ± 2. 3 ） weeks, （ 10. 8 ± 2. 1 ） weeks respectively, there was no statistical difference between two groups （ P 〉 0. 05 ）. Volar tihing angle, ulnar inclination angle, the length of radius and function recovery of wrist joint in the open reduction group were superior to those in the closed reduction groups. Conclusion The patients with distal radial fractures can be treated by open reduction and internal fixation. Adopting these therapentical measures will enable pa- tients to obtain reliable radial length recovery,early functional exercise to promote joint function recovery,shorter re- covery time, the ideal reduction quality and curative effect.