桡骨远端关节内骨折术后桡骨短缩的影响因素研究

Influencing factors of radius shortening after intra-articular fracture surgery of distal radius

目的对桡骨远端关节内骨折术后桡骨短缩的影响因素进行分析。方法回顾性分析2010年1月～2013年4月期间来我院进行手术治疗的81例桡骨远端关节内骨折患者的临床资料，将桡骨短缩距离在4mm以上的患者作为桡骨短缩组（n=23），将桡骨短缩距离在4mm以下的患者作为对照组（n=58），采用统计学方法对影响因素进行分析比较。结果桡骨短缩组患者的年龄明显高于对照组，术中植骨患者明显低于对照组，两组间的差异具有统计学意义（P〈0．05），C型骨折患者的桡骨短缩发生率与B型骨折患者比较明显较高，两组间差异具有统计学意义（P〈O．05）。而手术人路、内固定物的选择、末次随访掌倾角、尺偏角及Fernandez评分优良率在两组间差异均无统计学意义（P〉O．05）。结论桡骨远端关节内骨折具有较高的术后桡骨短缩发生率。采用手术对其进行治疗时应采取相应的防治措施对可能导致桡骨短缩的影响因素进行干预。

Objective To analyze the influencing factors of radius shortening after intra-articular fracture surgery of distal radius. Methods The clinical information of 81 patients with intra-articular fracture of distal radius underwent surgical treatment during January 2010 to April 2013 in our hospital were retrospectively analyzed. The patients with radius shortening distance more than 4ram were selected as the radius shortening group in 23 cases, while the patients with radius shortening distance less than 4mm were selected as the control group in 58 cases. The influencing factors were analyzed and compared by using statistical methods. Results The age in the radius shortening group was signifi- cantly higher than that in the control group, the patients with bone grafting were markedly lower than those in the control group, the differences between the two groups were statistically significant （P〈0.05）,and the incidence of ra- dius shortening of patients with type C fracture increased significantly compared with patients with type B fracture, the difference between the two groups was statistically significant （P〈0.05）. But the differences in surgical approach, selection of internal fixation, last follow-up palmaris inclination angle, angle of ulnar drift and Fernandez scoring ex- cellent rate between the two groups were not statistically significant （P〉0.05）. Conclusion Intra-articular fracture of distal radius has a high incidence of postoperative radius shortening. When using surgical treatment, the appropriate control measures should be taken to intervene possible influencing factors contributing to radius shortening.