外固定架与锁定加压钢板治疗C型桡骨远端骨折的疗效

Effect of external fixator and locking compression plate fixation in the treatment of type C distal radius fractures

目的对比切开复位锁定加压钢板与闭合复位外固定支架治疗C型桡骨远端骨折患者的临床疗效差异。方法以2010年1月-2014年1月收治的60例C型桡骨远端骨折患者作为研究对象,其中采用切开复位锁定加压钢板内固定治疗的患者34例（A组）,闭合复位外固定支架治疗的患者26例（B组）,两组患者手术均由同一组医师完成,对比两组患者的临床治疗效果差异。结果 A、B组患者术后3个月时的影像学指标掌倾角、尺偏角、桡骨高度测定值差异均不具有统计学意义（P〉0.05）。术后第6个月,A组患者的背伸角[（40.6±8.7）°]、掌倾角[（42.7±8.9）°]均显著高于B组[（34.8±5.5）°和（35.1±5.8）°,P〈0.05];两组患者的桡偏角、尺偏角、旋前角、旋后角测定值差异均不具有统计学意义（P〉0.05）。术后第6个月,A组患者的功能评分、活动范围评分、屈曲/伸展活动度评分均显著高于B组患者（P〈0.05）;两组患者的疼痛、握力差异均不具有统计学意义（P〉0.05）。术后第6个月,A组患者的腕关节功能显著优于B组患者（P〈0.05）。结论切开复位锁定加压钢板较闭合复位外固定支架治疗C型桡骨远端骨折更有利于患者术后腕关节的功能恢复。

Objective To compare the clinical efficacy of open reduction with locking compression plate fixation and closed reduction with external fixator for the treatment of patients with type C radial fractures. Methods Sixty cases of type C radial fractures who were admitted into our hospital from Jan. 2010 to Jan. 2014 were selected. Thirty-four patients were treated by open reduction and locking compression plate fixation（ group A）,26 patients were treated by closed reduction and external fixation（ group B）. The two types of surgery were performed by the same group of doctors. The clinical treatment effect of the two groups were compared. Results There was no statistical difference in the volar tilt angle,ulnar deviation angle and radial height at 3 months after operation between group A and group B（ P〈0. 05）. The dorsal extension angle[（ 40. 6 ± 8. 7） °] and palm flexion angle [（ 42. 7 ± 8. 9） °]in group A were significantly higher than those of patients in group B at six months after operation（ P〈0. 05）. No statistical difference was observed in radial deviation angle,ulnar deviation angle,pronation angle,and rotation angle after operation between the two groups（ P〈0. 05）. At sixth months after operation,the functional score,range of motion,flexion / extension of group A were significantly better than those in group B（ P〈0. 05）. There was no statistical difference in the pain and grip strength between the two groups. The wrist function of group A was significantly better than that of group B（ P〈0. 05）. Conclusion Open reduction with locking compression plate fixation is more conducive to the recovery of wrist joint function than closed reduction and external fixation in the treatment of patients with type C fracture of radius.