2种方法治疗桡骨远端骨折的疗效比较

Comparison of Two Treatment Methods for Distal Radius Fractures

目的比较分析2种不同方法(保守治疗及手术治疗)治疗桡骨远端骨折的疗效。方法将60例桡骨远端骨折患者按随机数字表法分为2组,每组30例。观察组采用切开复位"T"型钢板固定治疗,对照组采用手法复位+石膏固定治疗。术后复查X线片,并采用骨折功能恢复评价标准对2组患者的疗效(骨折复位及骨折功能恢复情况)进行比较。结果骨折复位效果:观察组优20例,良7例,可3例,优良率为90.0%;对照组优11例,良10例,可8例,差1例,优良率为70.0%。观察组骨折复位效果优良率明显高于对照组(χ2=5.026,P<0.05)。骨折功能恢复:观察组优21例,良8例,可1例,优良率为96.7%;对照组优10例,良12例,可6例,差2例,优良率为73.3%。观察组骨折功能恢复优良率明显高于对照组(χ2=6.703,P<0.05)。结论锁定钢板内固定能较好地复位骨折块,恢复和维持桡骨远端关节面的解剖复位,有利于患者早期进行腕关节的康复锻炼,尽早促进关节功能恢复。

Objective To compare the clinical efficacies of conservative treatment and surgical treatment for distal radius fractures. Methods Sixty patients with distal radius fractures were randomly divided into two groups, with 30 patients in each group. The observation group was treated with open reduction and T-plate fixation. The control group was treated with manipulative reduction and plaster fixation. Patients were reexamined postoperatively using X-ray tomography. According to the criteria for function evaluation, fracture reduction and functional recovery were compared between the two groups. Results In observation group, fracture reduction was excel- lent in 20,good in 7 and fair in 3 ,and functional recovery was excellent in 21 ,good in 8 and fair in 1. In control group, fracture reduction was excellent in ll,good in 10, fair in 8 and poor in 1, and functional recovery was excellent in 10, good in 12,fair in 6 and poor in 2. The excellent and good rates of fracture reduction and functional recovery in observation group （90.0% and 96.7%, re- spectively） were significantly higher than those in control group （70.0% and 73.3% ,respective- ly）（x2=5. 026 and x2 =6. 703,respectively;P〈0.05）. Conclusion Locking plate fixation can re- duce fracture fragments, restore and maintain anatomical reduction of distal radial articular sur-- face,facilitate early rehabilitation exercise, and promote joint function recovery in patients with distal radius fractures.