老年桡骨远端骨折的治疗手术治疗与非手术治疗的比较

Distal radial fractures in the elderly Operative versus nonoperative treatment

概要 根据2项回顾性队列研究的结论，对于老年桡骨远端骨折，手术治疗与非手术治疗相比，哪一种疗效更优目前仍无定论。与非手术治疗相比，接受手术治疗的患者术后可以获得较好的影像学结果，而功能恢复和活动范围的改善情况则两者相当。对于术后疼痛和握力的恢复情况，各研究结论不一。关节炎的发生情况，手术组低于非手术组。但1项研究则报道，对于关节外骨折的老年患者，手术治疗会明显增加关节炎的发生率。两种治疗方法间并发症的发生率差异无统计学意义。

Summary It is not possible from two retrospective cohort studies to draw definitive conclusions on the most effective treatment （operative versus nonoperative） for distal radial fractures in the elderly. Despite having better radio- graphic alignment, patients receiving operative care have similar functional outcomes and overall range of motion compared with those receiving nonoperative care. Results are mixed with respect to residual pain and grip strength. Arthritic changes tended to occur less frequently in pa- tients treated with surgery. However, one study reported a greater proportion of patients developed arthritis with operative treatment in those with extraarticular fractures. Complications were similar between groups.