经掌侧入路斜T型锁定加压钢板内固定治疗老年桡骨远端骨折的疗效分析

Curative effect of volar T-shaped plate internal fixation for elderly patients with distal radius fracture

目的 探讨经掌侧入路斜T型锁定加压钢板内固定对于治疗老年患者桡骨远端骨折的疗效。方法 选择2012年9月~2014年9月收治的85例桡骨远端骨折的老年患者,随机数字表法分为观察组45例和对照组40例,观察组采用经掌侧入路斜T型锁定加压钢板内固定,对照组采用经掌侧入路普通钢板内固定治疗,根据术后尺偏角、掌倾角、桡骨高度、桡腕关节面平整度参数和手术时间、术中出血量、住院时间、骨折愈合时间评估手术效果。结果 观察组骨折愈合时间显著短于对照组（P〈0.05）;两组尺偏角、掌倾角和桡腕关节面平整度等影像学参数差异有统计学意义（P〈0.05）,而桡骨高度差异无统计学意义（P〉0.05）;观察组优良率高于对照组优良率（P〈0.05）。结论 经掌侧入路斜T型锁定加压钢板内固定治疗老年患者桡骨远端骨折,功能恢复时间短、功能恢复较好,值得临床推广与应用。

Objective To investigate the curative effect of the volar T-shaped plate internal fixation for treatment of distal radius fracture in elderly patients. Methods Eighty-five elderly patients with distal radius fracture who were admitted into our hospital from Sep. 2012 to Sep. 2014 were randomly divided into the observation group（ n = 45） and the control group （ n = 40 ）. Patients in the observation group were treated by the volar T-shape plate internal fixation, and patients in the control group were treated by the volar anatomical plate internal fixation. The ulnar deviation angle, volar tilt angle,radial height ,flatness parameters of radial and carpal articular surface, operative time, blood loss,hospital stay,and fracture healing were recorded after operation. Results The healing time of the observation group was significantly shorter than that of the control group （P 〈 0. 05 ）. There were statistical differences in the ulnar deviation angle,volar tilt angle,radial height,and flatness parameters of radial and carpal articular surface between the two groups （P 〈 0. 05 ） ,but there was no significant difference in the radial height （ P 〉 0. 05 ）. According to the Gartland-Werley standard,the excellent and good rate of wrist joint function of the observation group was better than that of the control group. Conclusion The volar and good T-shaped plate internal fixation for distal radius fracture has advantages of short function recovery time and good functional recovery, which is worthy of clinical popularization and application.