桡骨远端关节内骨折术后短缩的相关因素分析

INFLUENCING FACTORS FOR RADIAL SHORTENING AFTER SURGICAL OPERATION FOR INTRAARTICULAR FRACTURES OF THE DISTAL RADIUS

目的分析桡骨远端关节内骨折术后桡骨短缩的相关影响因素,提高桡骨远端骨折的远期疗效,更好恢复患者腕关节功能。方法选择2010年1月—2012年1月唐山市第二医院手术治疗63例闭合桡骨远端骨折患者进行随访,根据桡骨短缩是否>4mm,分为桡骨短缩组(桡骨短缩距离>4mm)、对照组(桡骨短缩距离<4mm),分析术后桡骨短缩的相关影响因素。结果年龄、骨折类型、是否植骨、过早负荷为桡骨短缩的影响因素(P均<0.05),手术入路、是否合并尺骨茎突骨折、受伤至手术的时间、固定方式对桡骨短缩无明显影响(P>0.05),掌倾角和尺偏角比较差异无统计学意义(P>0.05),腕关节功能评分优良率短缩组低于对照组,差异有统计学意义(P<0.05)。结论手术时临床医生应考虑到导致桡骨短缩的影响因素,采用适当的防治措施,以减低术后桡骨短缩的发生。

Objective To analyze the relevant factors of the postoperative shortening at intra- articular fractures of distal radius, enhance the long- term effect of distal radius fracture, and to make wrist joint function in patients with better recovery. Methods This group was to be chosen from January 2010 to Jan- uary 2012, 63 patients with intra- articular fractures of distal radius were treated in author＇s hospital, who were followed- up. According to the radius shortening distance was greater than 4mm, patients were di- vided into radius shortening group （radial shortening distance was more than 4mm）, the control group （ra- dial shortening distance was less than 4mm）, and then analyzed the related factors influencing postoperative radial shortening. Results Age, type of fracture, whether bone inplant in operation and early load exercise were significantly different between the two groups （P〈0.05）. But surgical approach, whether of the ulna styloid bone, the time from injury to the operation, the choice of internal fixation had no statistically signif- icant difference in the two groups （P〉0.05）. Volar tilting angle and ulnar inclination angle were not also significantly different between the two groups （P〉0.05）. The excellent and good rate of function score was lower in the radial shortening group than the control group, with a significantly difference （P〈0.05）. Conclusion Clinical doctor should pay more attention to the influencing factors for radial shortening and take corresponding precaution methods during operation in order to reduce the incidence of radial shortening after operation for the intra - articular fractures of the distal radius.