手法复位小夹板外固定治疗老年桡骨远端骨折临床效果分析

Clinical Effect Analysis of Manual Reduction and Small Splint Fixation on Elderly Patients with Distal Radius Fracture

目的探讨手法复位治疗老年人桡骨远端骨折的临床效果。方法回顾性分析山东省平邑县人民医院2014年2月—2016年4月收治的107例桡骨远端骨折患者资料,行切开复位钢板内固定术者纳入对照组(n=58),骨折手法复位小夹板外固定者纳入观察组(n=49),比较两组患者术后疼痛缓解时间、骨折愈合时间、术后6个月掌倾角、尺偏角、腕关节功能恢复情况及并发症发生情况。结果疼痛缓解时间、骨折愈合时间观察组为(7.19±1.83)d和(9.25±2.04)周,对照组为(9.54±2.16)d和(12.26±3.71)周,观察组疼痛缓解时间、骨折愈合时间短于对照组,术后6个月尺偏角和掌倾角观察组分别为(11.82±1.92)°和(22.56±4.13)°,对照组分别为(11.49±2.04)°和(22.17±3.92)°,两组腕关节尺偏角和掌倾角差异无统计学意义,腕关节功能优良率对观察组为93.88%,对照组为93.10%,两组差异无统计学意义。术后并发症对照组为5.17%,观察组为6.12%,两组术后并发症发生率差异无统计学意义。结论手法复位小夹板外固定能够促进老年桡骨远端骨折的早期恢复,在腕关节功能恢复方面能够取得与切开内固定相同的效果,方法安全有效,是治疗老年人桡骨较为理想的方式。

Object ive To study the cl inical effect of manual reposition and small splint external fixation in treatment of senile fracture of distal end of radius. Methods 107 cases of patients with fracture of distal end of radius admitted and treated in our hospital from February 2014 to April 2016 were selected and divided into two groups, the control group with 58 cases adopted the open reduction and internal fixation with plate, the observation group with 49 cases adopted the manual reposition and small splint external fixation, and the postoperative pains relief time, fracture healing time, volar tilting angle in 6 months after operation, wrist joint function recovery and occurrence of complications were com-pared between the two groups. Results The pain relief time and fracture healing time in the observation group were shorter than those in the control group （7.19±1.83）d, （9.25±2.04）weeks vs （9.54±2.16）d, （12.26±3.71）weeks , and the ulnar inclination and volar tilting angle in 6 months after operation in the observation group and in the control group were respectively （11.82±1.92）.and （22.56±4.13） °and （11.49±2.04）0and （22.17±3.92）., and there were no obvious differences, and the excellent and good rate of wrist joint function in the observation group and in the control group was respectively 93.88% and 93.10%, and there was no obvious difference in the incidence rate of complications after operation between the two groups. Conclus ion The manual reposition and small splint external fixation can pro-mote the early recovery of senile fracture of distal end of radius, and it can obtain the same effect in the wrist joint function recovery with the incision internal fixation, and the method is safe and effective, which is an ideal method of treatment of senile radius.