有限切开复位克氏针内固定结合外固定支架治疗桡骨远端粉碎性骨折疗效分析

The efficacy of limited open reduction and Kirschner pins internal fixation combined with external fixation for the treatment of comminuted fractures of the distal radius

[目的]探讨桡骨远端粉碎性骨折行有限切开复位克氏针内固定结合外固定支架（LORIF＋EF）治疗的临床效果。[方法]2008年1月-2012年12月间本院采用切开复位克氏针内固定结合外固定支架治疗桡骨远端粉碎性骨折38例,筛选年龄、性别、骨折严重程度等相似的38例行切开复位锁定钢板内固定（ORIF）治疗的患者与其对照,评估两组患者在手术和住院时间、医疗花费、骨折复位、关节功能及并发症等方面的差异。[结果]两组患者均得到随访,期间未发生严重的并发症。两组患者在Sarmiento评分、Dienst评分、并发症发生率方面的差异无统计学意义;LORIF＋EF组在手术及住院时间、住院费用等方面显著低于ORIF组。[结论]对于桡骨远端粉碎性骨折的治疗,有限切开复位克氏针内固定结合外支架操作简单、固定确实、费用低、疗效满意。

[Objective]To explore the clinical outcomes of comminuted fractures of the distal radius treated with limited open reduction and Kirschner pins internal fixation combined with external fixation（ LORIF ＋ EF）. [Method]From Jan. 2008 to Dec. 2012,the clinical data of 38 cases with comminuted fractures of the distal radius treated with LORIF ＋ EF were analyzed retrospectively. The other 38 cases treated with open reduction and internal fixation（ ORIF） were included as a control group. The operative time,hospitalization,medical expenses,fracture reduction,the function of wrist and the incidence of post- operative complications were compared between the LORIF ＋ EF and ORIF groups. [Result]All the patients included were followed up and no serious complications occurred during those periods. The differences between the LORIF ＋ EF group and ORIF group were not statistically significant in the Sarmiento scores,Dienst scores and the incidence of postoperative complications,however,operative time,hospital stay and medical expenses in the LORIF ＋ EF group were significantly less than that in the ORIF group.[Conclusion]For the treatment of comminuted fractures of the distal radius,LORIF ＋ EF has advantages of simplifying surgical manipulation,lessening invasion,improving fixation,and low cost of the treatment,associated with satisfactory results.