影响桡骨远端粉碎性骨折疗效的相关因素

Influencing factors on clinical efficacy of distal radius fracture comminuted fracture

目的探讨影响手法复位夹板固定治疗桡骨远端粉碎性骨折疗效的相关因素。方法选择60例桡骨远端粉碎性骨折的患者为研究对象,所有患者均经手法复位夹板外固定法治疗。于治疗后1、2、4周及3个月时复查骨折部位正侧位X线片,测量治疗前后及3个月时患侧的掌倾角、尺偏角及桡骨缩短情况,3个月后对患者进行腕关节功能评分。分析腕关节功能与患者的年龄、骨折类型、影像学表现的关系。结果 36.7%的患者功能恢复为优,41.7%的患者为良,优良率达到78.4%。C2、C3型患者>60岁的患者优良率显著高于≤60岁的患者(P<0.05)。不同骨折类型之间优良率比较,差异有统计学意义(P<0.01)。复位后及愈合后>60岁组的患者掌倾角小于≤60岁组的患者(P<0.05或P<0.01)。结论不同骨折类型、患者的年龄以及影像学的表现与桡骨远端粉碎性骨折手法复位夹板外固定治疗后患者功能的恢复均有关系。

Objective To discuss influencing factors on clinical efficacy of distal radius fracture comminuted fracture. Methods Selected 60 cases with distal radius fracture comminuted fracture were treated by manual reduction and ex- ternal fixation. X ray were taken at 1, 2, 4 weeks and 3 months after treatment. Tilt changes and radial shortening were detected. Wrist joints function was evaluated after 3 months. Relationship between wrist joints function and age, clas- sification of fracture, image were analyzed. Results Wrist joints function of excellent was 36.7%, and good was 41.7%. The excellent and good rate was 78.4%. The excellent and good rate of over 60 years old were higher than ≤60 years old （P 〈 0.05 ）. The excellent and good rate of different classification of fracture were different （P 〈 0.01 ）. Palmar tilt of aged 〉60 group was less than aged ≤60 group（P 〈 0.05 or P 〈 0.01）. Conclusion Classification of fracture, age, radiographic results are relevant to wrist joints function of distal radius fracture comminuted fracture treated by manu- al reduction and external fixation.