不同内固定方法治疗桡骨远端粉碎性骨折的近远期疗效比较

Clinical comparison on short and long term efficacy of different internal fixation methods in treating distal radius comminuted fracture

目的：比较不同内固定方法治疗桡骨远端粉碎性骨折的近远期疗效。方法：选取2014年1月～2015年1月期间我院骨科收治的桡骨远端粉碎性骨折患者81例，随机分为A、B2组，A组47例进行有限切开复位克氏针内固定治疗，B组34例进行钢板内固定治疗，2组术后均进行6个月随访。参考Dienst腕关节功能评估比较2组临床疗效，采用Cooney腕关节评分评估2组术后6个月内不同时期腕关节功能，并比较2组并发症发生情况。结果：A组优良率为85．11％，略高于B组70．59％，差异比较无统计学意义（ P＞0．05）；A组术后1个月、3个月、6个月Cooney腕关节评分分别为63．22±8．13分、72．65±11．43分、86．70±13．45分，均明显高于B组（P＜0．05）；A组并发症发生率为8．51％，显著低于B组26．47％（P＜0．05）。结论：2种内固定方法治疗桡骨远端粉碎性骨折疗效均较为满意，但有限切开复位克氏针内固定治疗更有利于患者腕关节功能的恢复，且并发症明显较少，故推荐有限切开复位克氏针内固定治疗桡骨远端粉碎性骨折。

Objective： To compare short and long term efficacy of different internal fixation methods in treating distal radius comminu -ted fracture.Methods：81 cases of distal radius comminuted fracture treated in the department of orthopaedics of our hospital from January 2014 to January 2015 were selected, they were divided into group A and group B randomly , group A （47 cases） received limited open re-duction and Kirschner wire internal fixation , group B （ 34 cases ） received plate internal fixation , two groups were followed up for 6 months.Clinical efficacy of the two groups were evaluated referring to Dienst wrist joint function , Cooney wrist joint score was used to e-valuate wrist joint function of the two groups at different times of 6 months after the operation , complications of the two groups were com-pared.Results：Excellent and good rate of group A was 85.11%, which was slightly higher than the group B （70.59%） （P〈0.05）;Cooney wrist joint score of group A at 1 month, 3 months and 6 months after the operation were （63.22 ±8.13）scores, （72.65 ±11.43） scores, （86.70 ±13.45）scores respectively, which were significantly higher than group B （P〈0.05）;complication rate of group A was 8.51%, which was significantly lower than the group B （26.47%） （P〈0.05）.Conclusion：Efficacy of the two kinds of internal fixa-tion methods in treating distal radius comminuted fracture were satisfactory , but limited open reduction and Kirschner wire internal fixation was more beneficial to the recovery of patients＇wrist joint function , complications were significantly less , so limited open reduction and Kirschner wire internal fixation should be suggested for distal radius comminuted fracture .