掌侧锁定加压钛板与外固定支架治疗不稳定桡骨远端C型骨折的临床疗效分析

Analysis on clinical effect of volar side locking compression titanium plate and external fixation trestle for treating unstable type C distal radius fracture

目的对比分析掌侧锁定加压钛板与外固定支架治疗不稳定桡骨远端C型骨折的临床疗效。方法对该院2014年3月至2016年2月收治的78例不稳定桡骨远端C型骨折患者的临床资料进行回顾性分析。将患者按照不同治疗方式分为掌侧锁定板组与外固定支架组,每组39例,观察不同治疗方式治疗患者的临床疗效。结果外固定支架组患者术中出血量、手术时间、住院时间及骨折愈合时间均少于掌侧锁定板组(P<0.05);术后3d、6周、24个月,掌侧锁定板组患者掌倾角、尺偏角及桡骨高度明显优于外固定支架组(P<0.05);末次随访显示,两组患者掌屈活动度、背伸活动度、视觉模拟评分(VAS评分)、GartlandWerley评分比较差异无统计学意义(P>0.05);两组患者术后切口感染、腕管综合征及拇指伸长肌腱断裂发生率比较差异无统计学意义(P>0.05)。结论两种治疗方式均有较好的临床疗效。外固定支架治疗具有手术时间短、住院时间短等优点;而掌侧锁定加压钛板能在直视下复位骨折,且在掌倾角、尺偏角及桡骨高度恢复等方面明显优于外固定支架术,更加适合不稳定桡骨远端C型骨折患者。

Objective To comparatively analyze the clinical effects of volar locking compression titanium plate and external fixation trestle for treating unstable type C distal radius fracture. Methods The clinical data of 78 patients with unstable type C distal radius fracture treated in this hospital from March 2014 to February 2016 were analyzed retrospectively. The patients were divided into the yolar locking plate group and external fixattio trestle group according to different treatment methods, 39 cases in each group. The-clinical efficacies of different treatment methods were observed. Results The postoperative bleeding volume,operation time, hospitalization time and fracture healing time in the external fixation group were less than those in the volar locking plate fracture group（P〈0.05）. The palmar tilt angle,ulnar inclination angle and radial height on postoperative 3 d,6 weeks and 24 mopnths in the volar locking plate group were significantly better than those in the external fixation group（P〈0.05）. The last follow-up showed that the palmar flexion degree,dorsiflexion degree, VAS score and Gartland-Werley score had no statistical difference between the two groups（P〉0.05）. The incidence rates of postoperative incision infection, carpal tunnel syndrome and thumb extensor tendon rupture had no statistical differences between the two groups（P〉0.05）. Conclusion The two kinds of treatment method all have better clinical curative effect. The external fixation trestle treatment has the advantages Of shorter operation time and shorter hospitalization time, while the volar locking compression titanium plate can reset the fractures under direct vision,is significantly su- perior to the external fixation trestle treatment in the aspects of recovery of palmar tilt angle, ulnar inclination angle and radial height,and is more suitable for the patients with unstable type C distal radius fracture..