锁定加压钢板术与外固定架术对桡骨远端不稳定骨折患者生活质量的比较研究

Quality of Life in patients following treatment of unstable distal radial fractures with locking compression plate and external fixator： a comparative study

目的应用生活质量（QOL）评价锁定加压钢板（LCP）内固定术及外固定架（EF）术治疗桡骨远端不稳定骨折的疗效。方法选取2012年1月到2014年6月实行桡骨远端骨折手术的患者共50例，随机分至LCP术组及EF术组（各25例），剔除因失访并完成量表不完整的8例。比较两组患者术后3月与1年的生活质量及腕关节活动角度百分比、握力百分比、捏力百分比、腕关节功能评分、影像学指标等客观评定指标。同时对每组患者不同时段之间的以上参数进行比较。结果术后3月及1年时，大部分客观功能评定指标及生活质量的各领域评分，两组差异均无统计学意义。而在统计趋势上术后3月。EF术组较有优势，术后1年LCP术组较有优势。在治疗前后的比较中，LCP术组生活质量的改善较EF术组更为明显。结论术后早期及术后长期，两种术式患者的生活质量未见明显差异。两组术式患者术后长期的生活质量均明显优于术后早期。两种术式均可有效应用于桡骨远端不稳定骨折且有获得满意的长期疗效。

Objective To evaluate the efficacy of locking compression plate （LCP） internal fixation versus external fixator （EF） for the treatment of unstable distal radial fractures with the quality of life （QoL）. Methods A total of 50 patients who underwent surgery for unstable distal radial fractures between January 2012 and June 2014 were recruited and randomly divided into the LCP group and the EF group （n= 25 each）. Eight patients finally lost to follow-up or with incomplete scales were excluded. The QoL, the percentage ratios of ipsilateral to contralateral values in range of motion （ROM） , grip strength and pinch strength of wrist joint, wrist joint function score, the radiographic index and other objective indicators were compared between the two groups after 3 months and 1 year of the operation. Meanwhile, all the parameters at different time points of two groups were compared. Results At 3 months and 1 year ＂after the operation, there were no significant differences between the two groups in most objective functional indicators and the sub-scores of all QoL domains. Statistically, all these findings tended to favor the use of EF at 3 months, and favor the use of LCP at 1 year after the operation. Compared with before operation, the improvement in OoL was greater in the LCP group compared to the EF group. Conclusions There are no significant differences in short-term and long-term QoL between the two groups. In both groups, the long-term QoL is significantly better than the long-term QoL, suggesting that either of the surgical options can be effectively applied to treat unstable distal radial fractures with satisfatory long term efficacy.