不同治疗方法对儿童桡骨远端骨折的临床效果对照研究

Comparative study on clinical effects of therapeutic methods on child distal fracture of radius

目的:探讨不同方法治疗儿童桡骨远端骨折的临床效果。方法:选取2012年1月至2015年12月某院收治的儿童桡骨远端骨折患者180例(共212侧肢体),根据治疗方案的不同分为外固定支架组(58侧)、T形钢板内固定组(58侧)、克氏针内固定组(56侧)3个治疗组及1个采取手法复位石膏外固定的对照组(40侧),分别进行治疗。观察并记录4组患者临床疗效,并根据Dienst评定标准进行骨折功能评分。结果:外固定支架组、T形钢板内固定组、克氏针内固定组以及对照组的优良率分别为72.41%、53.57%、82.76%、45%。外固定支架组和T形钢板内固定组的优良率无明显差异(P>0.05),显著高于克氏针内固定组(P<0.05)。克氏针内固定组的优良率与对照组无明显差异(P>0.05)。外固定支架组和T形钢板内固定组、克氏针内固定组的满意度显著高于对照组(P<0.05)。结论:对于儿童桡骨远端骨折的治疗,外固定支架、T形钢板内固定法的疗效相比克氏针内固定法和传统手法复位更好。临床上应根据患者的骨折类型、稳定性、年龄及骨质情况、经济状况等综合考虑选择合适的治疗方案。

Objective To explore the clinical effects of therapeutic methods on child distal fracture of radius. Methods Totally 180 children with distal 212 fractures of radius from January 2012 to December 2015 in some hospital were enrolled into three treatment groups and a control group, of whom, there were 58 ones in a treatment group with external fixation support（external fixation group）, 58 ones in a treatment group with T-shaped plate internal support（T-shaped plate group）,56 ones in a treatment group with Kirschner wire internal fixation（Kirschner wire group） as well as 40 ones in the control group with manual reduction and plaster external fixation. The clinical effects in the four groups were observed, and function scoring was carried out according to Dienst standard. Results The excellent rates in the external fixation group, T-shaped plate group, Kirschner wire group and control group were 72.41%, 53.57%, 82.76% and 45% respectively. The external fixation group had the excellent rate with no significant difference with that in T-shaped plate group（P 0.05）, while obviously higher than that in Kirschner wire group（P 0.05）, and Kirschner wire group had the excellent rate statistically higher than that in the control group（P0.05）. The external fixation group, T-shaped plate group and Kirschner wire group had the satisfaction significantly higher than that in the control group（P 0.05）. Conclusion Compared with the traditional reduction and Kirschner wire fixation, the external fixation and T-shaped plate fixation have better clinical effects. The treatment of child distal fracture of radius should be planed according to the type of fracture, stability, age, economic condition and substance of the bones of the patient.