老年患者桡骨远端骨折手术与非手术治疗疗效比较

Comparison of the curative effect of operation and non operation treatment of distal radius fractures in elderly pa-tients

目的：比较手术与非手术治疗老年患者桡骨远端骨折的临床疗效。方法选取山西医科大学第一医院2012年4月至2014年4月收治的82例桡骨远端骨折老年患者为研究对象，其中手术治疗40例，为A组，非手术治疗42例，为B组，随访12～24周，比较两组患者临床疗效、并发症、腕关节功能指标（掌倾角、尺偏角及桡骨高度）、VAS评分及Cooney 评分。结果 A 组优良率、并发症发生率分别为87.5％、20.0％，与B组的76.2％、9.5％比较差异未见统计学意义（ P＞0.05）。随访24周，两组VAS评分、Cooney 评分比较差异未见统计学意义（P＞0.05）；但两组患者掌倾角（7.0°±13.5°vs 2.4°±11.3°）、尺偏角（23.7°±3.8°vs 20.4°±3.5°）、桡骨高度[（9.0±1.5）mm vs（7.8±2.2）mm]比较差异有统计学意义（P＜0.05）。结论手术与非手术治疗老年患者桡骨远端骨折手术远期疗效相似，根据患者意愿及骨折类型合理选择。

Objective To compare the clinical curative effect of operation and non operation treatment on senile fracture of the distal radius in elderly patients .Methods From April 2012 to April 2014, eighty two elderly patients with distal radius fracture were selected as the research objects , 40 patients were given the operation treatment （ group A） , and 42 patients were given the non operation treatment （group B）.They were all followed up for 12 to 24 weeks, and then compared the clinical curative effect , complications, wrist joint function index（Palm angle, ulnar deviation and radial height ）, VAS score and Cooney score of the two groups .Results In group A, the excellent and good rate , complication rate were 87.5%, 20%, respectively, and 76.2%, 9.5%in group B, the differences were no significant between the two groups （P〉0.05）.Follow up for 24 weeks, the VAS score, Cooney score had no significant difference between the two groups （P＆gt;0.05）;But the differences of palmar tilt （7.0°±13.5°vs 2.4°±11.3°）, ulnar inclination（23.7°±3.8°vs 20.4°±3.5°）, and high degree of radius[（9.0 ±1.5）mm vs（7.8 ±2.2）mm] were significantly diffevent between the two groups （P〈0.05） .Conclusions Long-term results of operation treatment of fracture are similar to those of non operation treatment , a reasonable treatment is selecteol according to the willingness of patients and the types of fracture .