手法复位石膏外固定联合中药熏洗和切开复位钢板内固定治疗骨质疏松性桡骨远端骨折疗效比较

Comparative Study of Manipulative Reduction and Plaster External Fixation Combined with Chinese Herbal Fumigation versus Open Reduction and Plate Internal Fixation for Treating Osteoporotic Distal Radius Fractures

目的比较手法复位石膏外固定联合中药熏洗和切开复位钢板内固定治疗骨质疏松性桡骨远端骨折的疗效。方法回顾分析2015年6月—2017年1月68例骨质疏松性桡骨远端骨折病例资料,其中手法复位石膏外固定联合中药熏洗组(石膏组)33例,切开复位钢板内固定组(钢板组)35例,比较两组骨折愈合时间,观察治疗6个月后两组患者掌倾角、尺偏角和桡骨高度、腕关节活动度、Robbins腕关节评分及并发症发生情况。结果石膏组骨折愈合时间短于钢板组(P<0.01),治疗6个月后石膏组掌倾角、尺偏角、桡骨高度均小于钢板组(P<0.05)。两组腕关节活动度及Robbins腕关节评分比较,差异无统计学意义(P>0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论切开复位钢板内固定治疗老年骨质疏松性桡骨远端骨折在骨折复位方面优于手法复位石膏外固定联合中药熏洗组,但骨折愈合时间长于后者,在功能恢复及安全性方面两者无明显差异。

Objective To compare the clinical curative effect of manipulative reduction and plaster external fixation combined with Chinese herbal fumigation versus open reduction and plate internal fixation in treating osteoporotic distal radius fractures. Methods The medical records of 68 patients with osteoporotic distal radius fractures from June 2015 to Jan. 2017 were analyzed retrospectively. Thirty-three patients were treated with manipulative reduction and plaster external fixation combined with Chinese herbal fumigation(plaster group), while the others(35 cases)were treated with open reduction and plate internal fixation(plate group). The fracture healing time, volar tilt angles, radial inclination angles, radial height, wrist joint activity, Robbins wrist scores and complications were recorded and compared between the two groups after 6 months treatment. Results The fracture healing time in plaster group were shorter than plate group(P<0.01). Volar tilt angles, radial inclination angles and radial height were less in plaster group compared to plate group after 6 months treatment(P<0.05). There was no statistical difference in wrist joint activity, Robbins wrist scores and complications between the 2 groups after 6 months treatment(P>0.05). Conclusion For osteoporotic distal radius fractures, open reduction and plate internal fixation surpasses manipulative reduction and plaster external fixation combined with Chinese herbal fumigation in fracture reduction, but longer the time of fracture healing, and there was no significant difference in functional recovery of wrist joint and safety between the two therapies.