桡骨远端楔形截骨术与背侧入路手术治疗腕舟骨不稳定骨折的临床疗效对比分析

Comparative Analysis of Clinical Effect of Distal Radius Wedge Osteotomy and Dorsal Approach Operation in the Treatment of Unstable Fractures of Scaphoid

目的探讨桡骨远端楔形截骨术及背侧入路术对腕舟骨不稳定骨折的临床疗效。方法收集我院2011年5月至2014年2月收治的76例腕舟骨不稳定性骨折患者,随机分为两组各38例。观察组采用桡骨远端楔形截骨术治疗,对照组采用背侧入路术治疗。比较两组的治疗效果以及手术前后VAS评分和腕关节活动度。结果观察组治疗后优良率为92.11%,显著高于对照组的73.68%,差异具有统计学意义(P<0.05)。两组患者术前VAS评分比较无明显差异(P>0.05),两组患者术后1个月、3个月、6个月的VAS评分均显著降低,且观察组明显低于对照组,差异具有统计学意义(P<0.05)。两组患者术前腕关节活动度相比无明显差异(P>0.05),两组术后1个月、3个月、6个月的腕关节活动度均优于术前,且观察组明显优于对照组,差异具有统计学意义(P<0.05)。结论桡骨远端楔形接骨术对腕舟不稳定骨折患者进行治疗,操作简单,且疗效确切,值得临床推广。

Objective To investigate the clinical effect of distal radius wedge osteotomy and dorsal approach surgery in the treatment of unstable fractures of scaphoid. Methods 76 cases of patients with unstable fractures of scaphoid treated in our hospital from May 2011 to February 2014 were collected and randomly divided into two groups, with 38 cases in each group. The observation group was treated with distal radius wedge osteotomy, and the control group was treated with dorsal approach surgery. The clinical effect, VAS score and wrist movement before and after surgery were compared between two groups. Results The excellent and good rate of the observation group was 92.11%, higher than 73.68%of the control group, with statistical difference （P〈0.05）. The VAS score of the two groups before the operation had no statistical difference （P〉0.05）, and after 1 month, 3 months and 6 months of the surgery, the VAS score of the two groups decreased, and the VAS score of the observation group was lower than that of the control group, with statistical difference （P 〈0.05）. The wrist movement of the two groups before the operation had no statistical difference （P〉0.05）, and after 1 month, 3 months and 6 months of the surgery, the wrist movement of the two groups were improved, and the wrist movement of the observation group was better than that of the control group, with statistical difference （P 〈0.05）. Conclusions For patients with unstable fractures of scaphoid, distal radius wedge osteotomy has simple operation and accurate effect, which is worthy of clinical promotion.