外固定架+克氏针治疗C型桡骨远端骨折的临床疗效分析

The Clinical Effect of Two Kinds of External Fixation for the Treatment of Type C Distal Radius Fractures

目的对比外固定架、外固定架+克氏针治疗C型桡骨远端骨折临床疗效。方法 2010年1月至2015年12月笔者科室共收治的250例桡骨远端骨折患者中,52例患者符合标准纳入研究分析,根据其治疗方式分为两组外固定架组,22例;外固定架+克氏针组,30例。对比术后1、6周掌倾角、尺倾角及桡骨高度变化,半年随访时Dienst腕关节功能评分,进行临床疗效比较。结果 52例患者均获得完整随访,随访时间最长26个月,最短6个月,平均12.5个月,骨折均愈合。外固定架组术后1、6周掌倾角、尺倾角及桡骨高度变化较外固定架+克氏针组明显,对比存在显著性差异(P<0.05);半年随访Dienst腕关节功能评分优良率:外固定组63.6%,外固定架+克氏针组90%,两组对比统计学具有显著性差异(P<0.05)。结论外固定架+克氏针治疗C型桡骨远端骨折具有操作简单,微创,费用相对低廉,比单纯外固定架骨折端更稳定,临床疗效满意,值得推广。

Objective To compare the clinical efficacy of external fixator ＋ Kirschner wire and external fixator in treatment of type C distal radius fractures. Methods From January 2010 to December 2015, 250 cases of patients with distal radius fracture were treated in our Department. 52cases were selected in our study. They were divided into two group according to the way of treatment： external fixator group, 22 case; external fixator＋Kirschner wire group, 30 case. To compare the change of the radial inclination angle, the palmar tilt angle and the radial styloid height inlweek and in 6week after operation. Dienst criteria by half year after operation were compared. Results 52 case were followed up from 6 months to 26 months （12.5 months on average）. According to the anatomical alignment. The change of the radial inclination angle, the palmar tilt angle andthe radial styloid height in 1 week and in 6week after operation had significant difference（P〈0.05） ; the excellent and good rate of Dienst criteria of external fixator ＋ Kirschner wire group was 90%, external fixator group was 63.6%, external fixator ＋ Kirschner wire group was significantly higherthan external fixator group, the difference was statistically significant （P〈0.05）. Conclusion External fixator ＋ Kirschner wire for the treatment of type C distal radius fractures has the advantages of simPle operation, minimally invasive and relatively low cost, it was more stable than the external fixator, and the clinical effectiveness was satisfactory.