切开复位锁定加压钢板内固定与闭合复位外固定支架固定治疗桡骨远端骨折的比较

Comparison of the Open Reduction Combined with Locking Compression Plates Fixation and the Closed Reduction Combined with External Fixation for the Treatment of Distal Radius Fractures

目的比较切开复位锁定加压钢板内固定与闭合复位外固定支架固定治疗桡骨远端骨折的疗效与安全性。方法选取2012年1月至2016年1月于我院接受治疗桡骨远端骨折的62例患者为研究对象,其中30例采用的是切开复位锁定加压钢板内固定,其余32例则采用闭合复位外固定支架固定。回顾性分析比较两组患者的手术情况、骨折愈合时间以及术后不同时间的腕关节主动活动度。结果内固定组患者的术中出血量和手术时间均多于外固定组(P<0.05),但两组患者的并发症发生率差异无统计学意义(P>0.05);内固定组患者的骨折愈合时间长于外固定组(P<0.05);内固定组患者的腕关节主动活动度在术后3个月时小于外固定组(P<0.05),但两组患者在术后1年后的腕关节主动活动度差异无统计学意义(P>0.05)。结论两种治疗方法对桡骨远端骨折均具有较高的疗效与安全性,但是闭合复位外固定支架固定的疗效更为显著,且避免了二次手术,值得临床推广应用。

Objective To compare the efficacy and safety of the open reduction combined with locking compression plates（LCP） fixation and the closed reduction combined with external fixation for the treatment of distal radius fractures.Methods 62 patients with distal radial fractures were studied from January 2012 to January 2016 in our hospital,of which 30 cases were treated with the open reduction and LCP fixation,and the other 32 patients were treated with closed reduction and external fixation.The operation indexes of the two groups,healing time of the fracture and the function of the wrist joint after operation were compared.Results It showed that blood loss and operative time of the internal fixation group were more than the external fixation group （P ＜ 0.05）.But there was no significant difference in the complication rates between the two groups （P ＞ 0.05）.Fracture healing time of the internal fixation group was longer than that of the external fixation group （P ＜ 0.05）.The 3-month postoperative wrist activity angles of the internal fixation group was less than the external fixation group （P ＜ 0.05）,but the 1-year angles had no difference （P ＞ 0.05）.Conclusion It is effective and safe of the two kinds of reduction and fixation methods for the radius fractures patients with high rehabilitation.But the closed reduction combined with external fixation is recommended as the first choice for its high curative effect with no need of a secondary procedure.