特定桡骨远端骨折患者手术及手法复位治疗后的远期效果对比

Comparison of long-term efficacy in the specific distal radius fractures in patients with surgery and manual reduction treatment

目的比较特定桡骨远端骨折(DRF)患者手术及手法复位治疗后的远期疗效。方法选择2007年8月～2012年8月恩施州民族医院治疗的100例DRF患者,分为对照组与观察组,每组各50例。对照组给予手法复位治疗,观察组给予手术治疗,比较两组Krimmer评分、掌倾角、尺偏角、愈合情况等。结果①观察组治疗后0.5、1、2年的Krimmer评分优良率[76.00%(28/50)、82.00%(41/50)、90.00%(45/50)]与对照组[66.00%(33/50)、74.00%(37/50)、82.00%(41/50)]比较,差异均有统计学意义(P<0.05)。②对照组掌倾角及尺偏角术后0.5、1、2年与术前比较,差异均具有统计学意义(P<0.05);观察组治疗后0.5、1、2年掌倾角及尺偏角与术前比较,差异均有统计学意义(P<0.05或P<0.01),且观察组掌倾角及尺偏角治疗后0.5、1、2年与对照组治疗后同时间比较,差异有统计学意义(P<0.05)。③观察组患者骨折临床愈合率[94.00%(47/50)]高于对照组[88.00%(44/50)],差异有统计学意义(χ2=5.635,P<0.05),两组延迟愈合率差异无统计学意义(P>0.05)。结论特定DRF患者手术治疗方式,远期疗效尤佳,应在临床上加以推广并应用。

Objective To compare long-term efficacy in the specific distal radius fractures （DRF） in patients with surgery and manual reduction treatment. Methods 100 patients with DRF in National Hospital of Enshi Prefecture from August 2007 to August 2012 were selected and divided into control group and observation group with 50 cases in each group. The control group was given the manual reduction treatment, and the observation group was given surgery treatment. Krimmer score, palmar angle, ulnar deviation, healing situation were compared between the two groups. Results （~）The excellent and good rate in Krimmer score of 0.5, 1, 2 years in observation group [76.00%（28/50）, 82.00%（41/50）,90.00%（45/50）] were higher than those in control group [66.00%（33/50）, 74.00% （37/50）, 82.00% （41/50）], the differences were statistieally significant （P 〈 0.05）. （~）The differences of palmar angle, ulnar deviation in control group before and 0.5, 1, 2 years after the operation were statistically significant （P 〈 0.05）; the differences of palmar angle, ulnar deviation in observation group before and 0.5, 1, 2 years after the operation were statistically significant （P 〈 0.05 or P 〈 0.01）, the differences of palmar angle, ulnar deviation 0.5, 1, 2 years after the operation between the two groups were statistically signifieant （P 〈 0.05）.（2）The clinical healing rate of fractures in observation group [94.00%（47/50）] was higher than that in control group [88.00% （44/50）], the difference was statistically significant （X2 = 5.635, P 〈 0.05）; the difference of delayed union rate between the two groups was not statistically significant （P 〉 0.05）. Conclusion The surgical treatment of specific DRF patients has a long-term efficacy, and it is worthy of promotion on the clinical application.