两种固定术治疗桡骨远端C型骨折的疗效比较

Efficacy comparison of two different fixation methods in type C fractures of distal radius

目的比较锁定加压钢板固定和克氏针联合支架外固定治疗桡骨远端C型骨折的疗效。方法将86例桡骨远端C型骨折患者按手术方式分为A组(44例,采用克氏针联合支架外固定)和B组(42例,采用锁定加压钢板固定)。结果患者均获得16个月随访。两组患者骨折愈合情况及术后并发症发生情况比较差异均无统计学意义(P>0.05)。C2和C3型骨折患者的桡骨远端短缩程度A组明显少于B组,差异有统计学意义(P<0.05)。术后16个月的腕关节功能评分:C1和C2型骨折患者两组比较差异无统计学意义(P>0.05),C3型骨折患者A组优于B组,差异有统计学意义(P<0.05)。屈腕与伸腕活动度A组显著高于B组(P<0.01)。结论锁定加压钢板固定或克氏针联合支架外固定治疗桡骨远端C1、C2型骨折患者疗效均可;对于严重的C3型桡骨远端骨折患者,克氏针联合支架外固定治疗效果更好。

Objective To compare the efficacy of Kirschner wire combined with external fixation and locking compression plate in treatment of type C fractures of distal radius. Methods The 86 cases with type C fractures of distal radius were divided into two groups according to the fixation methods. Forty-four patients in group A were treated with Kirschner wire combined with external fixation; 42 patients in group B were treated with locking compression plate. Results All cases were followed up for 16 months postoperatively, the healing and postoperative complications showed no significant difference between two groups （P 〉 0. 05）. Patients with type C2 and C3 fracture in group A showed less radius distal short shrinking degree than those in group B （P 〈 0. 05 ）. At 16 months postoperation, patients with type C1 and C2 fractures showed no significant difference in wrist joint function between two groups （ P 〉 0.05 ）. Patients with type C3 fractures in group A showed better wrist joint function than those in group B, with significant difference （P 〈 0. 05）. Wrist flexion and stretch wrist activity degree in group A were significantly higher than those in group B （P 〈 0. 01 ）. Conclusions Either locking compression plate fixation or Kirschner wires combined with external fixation for patients with type C1 or C2 fractures of distal radius shows equal efficacy; for severe patients with type C3 fractures of distal radius, Kirschner wire combined with external fixation shows better therapeutic effects.