锁定钢板内固定联合抗骨质疏松药治疗老年桡骨远端骨折的效果观察

Efficacy of locking plate fixation with anti-osteoporosis drug treatment of distal radius fracture in elderly

目的 探讨锁定钢板内固定联合抗骨质疏松药治疗老年桡骨远端骨折的效果.方法 选择2010年2月～2013年9月唐山市中医医院住院治疗的老年桡骨远端骨折患者43例,随机分为观察组（22例）和对照组（21例）.两组患者均给予锁定钢板内固定治疗,观察组同时给予阿仑膦酸钠70 mg口服,1次/周,疗程为6个月.观察两组患者腕关节功能恢复情况、术后不良反应及术后半年骨密度的变化.术后1年进行随访,观察两组患者再骨折的发生情况.结果 观察组患者腕关节功能恢复情况：优17例、良3例、可2例、无差病例;对照组分别为：优16例、良3例、可2例、无差病例,差异无统计学意义（P＞0.05）.术后均无感染、正中神经炎、骨不连及钢板松动等并发症.术后1年观察组骨折再发生率为4.5％（1/22）,对照组为23.8％（5/21）,差异有统计学意义（P＜0.05）.术后6个月观察组骨密度为（0.80±0.10）g/cm2、对照组为（0.63±0.03）g/cm2,差异有统计学意义（P＜0.05）.结论 老年桡骨远端骨折患者采用锁定钢板内固定联合抗骨质疏松药治疗,腕关节功能恢复良好,并发症少,再骨折发生率降低,值得临床推广应用.

Objective To discuss the effect of the locking plate fixation with anti-osteoporosis drug in the treatment of distal radius fracture. Methods From 2010 February to 2013 September, in Tangshan City Traditional Chinese Medicine Hospital, 43 elderly patients with distal radius fracture were divided into observer group（22 cases） and control group（21 cases）. All patients were treated with locking plate fixation the patients in the observation group were given Alendronate Sodium 70 mg orally, 1 time/week, treated for 6 months. The wrist joint function recovery, postoperative untoward reaction and the first half of the postoperative changes of bone mineral density were recorded. After 1years follow-up, refracture occurrence situation of two groups were recorded. Results Wrist joint function recovery in observer group： 17 cases were excellent, 3 cases were good, 2 cases were fair, no bad; in control group： 16 cases were excellent, 3 cases were good, 2 cases were fair, no bad, the difference between the two groups had no statistical significance（P 〈0.05）. There was no median neuritis, infection, bone nonunion and plate loosening happened after operation. 1years after operation, the refracture rate of observer group was 4.5%（1/22）, which of control group was 23.8%（5/21）,there was significant difference between two groups（P 〈0.05）. 6 months after operation, the bone density of the observer group was（0.80±0.10） g/cm2, which of the control group was（0.63±0.03） g/cm2, there was significant difference between two groups（P 〈0.05）. Conclusion The effect of locking plate fixation with anti-osteoporosis drug is better,wrist joint function recovers well, less complications, the refracture rate is less. It is worthy of clinical application.