桡骨远端骨折手术与非手术治疗的疗效比较

Distal radius fracture:operative compared with nonoperative treatment

目的比较手术与非手术治疗桡骨远端骨折的疗效。方法选取自2010—01—2013—06收治的桡骨远端骨折264例268侧，采取手法复位石膏外固定桡骨远端骨折168例171侧，切开复位内固定手术治疗桡骨远端骨折患者96例97侧（含因手法复位再移位者8例8侧）。结果264例获得随访12～36个月（平均26个月）。腕关节功能评价根据Cooney标准进行评定：手法复位石膏外固定组优良率为84．8％，切开复位内固定手术治疗组优良率为95．9％。结论对于不稳定桡骨远端骨折的治疗，切开复位内固定手术治疗优于手法复位石膏外固定，但由于手法复位石膏外固定方法简单、费用低廉、患者痛苦较小，故仍可作为稳定或相对稳定性桡骨远端骨折的首选治疗方法。

Objective To explore the therapeutic effects between the conservative treatment （ reduction and plaster external fixation ） and surgical treatment （ reduction and plate intemal fixation ）. Methods Two hundred and sixty eight sides of 264 patients with distal radius fracture were investigated from Jan. 2010 to Jun. 2013. One hundred and seventy one sides of 168 patients were treated by reduction and plaster external fixation. Ninety seven side （ including 5 side of 5 patients with failure conservative treatment ） of 96 patients were treated by reduction and plate internal fixation. Results Two hundred and sixty eight sides of 264 patients were followed up for 12 to 36 months （mean 26 months）. Joint function was evaluated by Cooney. The good and excellent rate in conservative treatment group was 84.8%, in surgical treatment group 95.9%. Conclusion Surgical treatment in therapy of instability distal radius fracture is better than conservative treatment. Reduction and piaster external fixation is the first therapeutics for stable distal radius fracture or relatively stable distal radius fracture because of its simple, cheap and minor pain.