外固定支架与锁定加压钢板应用于桡骨远端C型骨折治疗的疗效比较

Contrastive analysis of the curative effect of external fixation holder and locking compression plate on C-type fracture of distal radius

目的 比较外固定支架固定和锁定加压钢板内固定治疗桡骨远端C型骨折的临床疗效。方法 选取于我院接受治疗的77例桡骨远端C型骨折患者为研究对象,根据治疗方法不同分为内固定组和外固定组。外固定组采用外固定支架固定治疗,内固定组采用锁定加压钢板内固定治疗,治疗后比较两组患者术后桡骨高度、掌倾角、尺偏角,采用改良GW评分评估患者术后6、12个月的腕关节功能。结果 两组患者术后均随访6-12个月,术后行腕关节标准正侧位X片影像学测量发现,内固定组患者术后桡骨高度、掌倾角、尺偏角分别为（9.58±0.67）mm、（9.54°±0.78°）及（21.39°±0.76°）,与外固定组患者的（9.39±0.65）mm、（9.46°±0.73°）及（21.20°±0.71°）相比,差异无统计学意义（P〉0.05）;术后6个月,内固定组GW评分为（3.32±1.20）分,明显低于外固定组的（5.54±1.57）分,组间比较差异明显（P〈0.05）;术后12个月,两组患者的GW评分比较,差异无统计学意义（P〉0.05）。结论 外固定支架与锁定加压钢板治疗桡骨远端C型骨折疗效均较好,锁定加压钢板固定短期内关节功能恢复较外固定支架好,远期疗效无明显差异。

Objective To investigate the curative effect of external fixation holder and locking compression plate on C-type fracture of distal radius. Methods Seventy-seven cases of patients with C-type fracture of distal radius were selected in our hospital and divided into internal fixation group and external fixation group. The postoperative radial height, palmaris inclination, angle of ulnar drift, modified GW score were recorded to evaluate the wrist joint function between the two groups 6, 12 months after surgery. Results The patients were followed up for 6 to 12 months after operation. The X slice imaging measurement of standard positive lateral position of wrist joint after surgery showed that the postoperative radial height, palmaris inclination, angle of ulnar drift in the internal fixation group were （9.58＋0.67） mm, （9.54±0.78°）and （21.39±0.76°）respectively, while in the external fixation group were （9.39＋0.65） mm, （9.460＋0.73°） and （21.20±0.71°） respectively, there were no differences between the two groups （P〉0.05）. At 6 months after the surgery, the score of GM in internal fixation group was （3.32±1.20）, which was lower than （5.54±1.57） in external fixation group, the difference between two groups was significant （P〈0.05）. At 12 months after the surgery, the difference of GM scores in the two groups was not statistically significant （P 〉0.05）. Conclusion Both external fixation holder and locking compression plate have a good curative effect of on C-type fracture of distal radius. Locking compression plate fixation has a better joint function recovery in the short term than the external fixation, while the long-term effect has no significant difference.