保守与手术治疗老年糖尿病合并桡骨远端骨折的疗效探讨

The Comparation of Nonoperation and Operation for Treatment of Senile Diabetes Combined Distal Radius Fracture

目的探讨保守和手术两种不同方法治疗老年桡骨远端骨折的疗效。方法采用手法复位小夹板外固定（A组42例）、切开复位接骨板内固定（B组39例）治疗81例患者。比较6个月时桡骨高度、掌倾角、尺偏角,采用改良GartlandWerley（GW）评分评定术后6、12个月的腕关节功能。结果随访时间范围在12~24月之间（平均21.4月）,骨折愈合时间范围在2~3月之间。术后6个月A组桡骨高度和尺偏角差于B组（P〈0.05）,改良GW评分A组（6.31±1.17）与B组（3.81±1.17）的差异也有统计学意义（P〈0.05）。12个月时A组的桡骨高度及尺偏角与B组的差异有统计学意义（P〈0.05）,但改良GW评分差异无统计学意义。结论老年糖尿病合并桡骨远端骨折采用手法复位小夹板外固定较手术治疗的早期腕关节功能差,远期功能良好。

Objective To compare the clinical efficacy of nonoperation and operation in treating senile diabetes combined distal radius fracture.Methods 81 patients treated with manipulative restoration and external fixation（42 cases,group A）,39 cases（group B） treated by openning restoration and T plate internal fixation.Radial height.volar tilt,radial inclination were compared,the modified GartlandWerley scores were used to assessed wrist joint function after 6 and 12 months following up.Results All patients were followed up from 12 to 24 months,with an average of 21.4months.All the patients achieved bony union after 2 to 3 months.Compared with group B,the group A shoetened in radial height,radial inclination and modified Gartland-Werley scores after treated 6 months,the difference showed statistical significance,At 12 months after the treatments,the modified Gartland-Werley scores with no statistical significance in two groups.Conclusions That disadvantaged in early for manipulative restoration and external fixation treated senile diabetes combined distal radius fracture,but advantaged after 12 months.