手法复位夹板外固定与切开复位钢板内固定治疗老年桡骨远端C型骨折的临床疗效和安全性

Clinical Curative Effect and Safety of Manual Reduction External Fixation and Open Reduction and Internal Fixation with Plate in Treatment of Senile Type-c Fracture of the Distal Radius

目的探讨和分析手法复位夹板外固定与切开复位钢板内固定治疗老年桡骨远端C型骨折的临床疗效和安全性。方法研究方便选择2015年6月—2017年3月间该院收治的74例老年桡骨远端C型骨折患者当做研究对象,按入院顺序分成甲组(37例)和乙组(37例)。甲组患者通过手法复位夹板外固定进行治疗,乙组患者通过切开复位钢板内固定进行治疗,评价甲乙两组患者的尺偏角、掌倾角、治疗优良率、并发症情况。结果甲组患者的尺偏角(15.87±6.92)°、掌倾角(3.02±7.16)°与乙组(21.18±2.88)°、(10.36±1.88)°相比,差异有统计学意义(P<0.05)。甲组治疗总优良率(81.08%)、并发症发生率(8.11%)与乙组相比83.78%、10.81%相比,差异无统计学意义(P>0.05)。结论在老年桡骨远端C型骨折的治疗中,切开复位钢板内固定同手法复位夹板外固定比较,治疗效果和安全性相近,但在骨折解剖复位上切开复位钢板内固定的效果比较好,在治疗时应根据患者情况制定治疗方案。

Objective To study and analyze the clinical curative effect and safety of manual reduction external fixation and open reduction and internal fixation with plate in treatment of senile type-c fracture of the distal radius. Methods 74 cases of senile patients with type-c fracture of the distal radius admitted and treated in our hospital from June 2015 to March2017 were convenient selected and divided into two groups with 37 cases in each according to admission order, the group A and group B respectively adopted the manual reduction external fixation and open reduction and internal fixation with plate,and the ulnar inclination and volar tilting angle and excellent and good rate and complications were evaluated. Results The differences in the ulnar inclination and volar tilting angle between the two groups were statistically significant [（15.87 ±6.92）°,（3.02±7.16）° vs（21.18±2.88）°,（10.36±1.88）°]（P〈0.05）, and the differences in the total excellent and good rate and incidence rate of complications between the group A and group B were not statistically significant（81.08%, 8.11% vs83.78%,10.81%）,（P〈0.05）. Conclusion The effect and safety of manual reduction external fixation and open reduction and internal fixation with plate in treatment of senile type-c fracture of the distal radius are similar, but the effect of open reduction and internal fixation with plate is better, and we should make the treatment plan according to the specific situations of patients.