老年桡骨远端骨折病人应用万向掌侧接骨板治疗的疗效及对生活质量的影响

Clinical effect and quality of life of elderly patients with distal radius fractures treated with volar variable-angle locking plate

目的评价应用万向掌侧接骨板治疗老年桡骨远端粉碎性骨折病人的效果及其对生活质量的影响。方法回顾性分析我院2013年2月至2016年2月收治的60岁以上桡骨远端粉碎性骨折病人68例,研究组38例应用万向掌侧锁定加压接骨板治疗,对照组30例接受外固定支架治疗。对比2组骨性愈合时间和并发症,分别测量术后3个月、12个月标准正侧位X片掌倾角、尺偏角、桡骨高度,同时以丁斯特等级评分(Dienst)、腕关节病人自行评估量表(PRWE),焦虑自评量表(SAS)为评定标准,对病人治疗后生活质量进行评价。结果 68例病人1年随访时骨折均获骨性愈合,对照组骨性愈合时间短于研究组(P>0.05);研究组并发症发生率低于对照组(P<0.05);术后3个月,研究组掌倾角优于对照组(P<0.05);术后12个月,研究组掌倾角、桡骨高度均优于对照组(P<0.05);术后3个月,研究组Dienst等级评分优于对照组(P<0.05);术后3个月、12个月,研究组PRWE评分、SAS评分均低于对照组,差异均有统计学意义(P<0.05)。结论万向掌侧锁定加压接骨板更有利于提高老年桡骨远端粉碎性骨折病人的生活质量。

Objective To evaluate the clinical effect and quality of life of elderly patients with distal radius fractures treated with volar variable-angle locking plate. Methods A retrospective analysis was carried out in 68 elderly patients with distal radius comminuted fracture aged over 60 years of our hospital from February 2013 to February 2016. Patients were divided into two groups,38 cases in study group treated with volar variable-angle locking plate,30 cases in control group treated with external fixation. Bone healing time and the complication rate,the standard anteroposterior and lateral X-ray of the palmar tilt,ulnar inclination and radial height were observed and compared 3 months and 12 months after treatment. Dienst,Patient-Rated Wrist Evaluation（ PRWE） and Self-Rating Anxiety Scale（ SAS） were assessed to evaluate the quality of life. Results Bone healing time of control group was shorter than that of study group（ P〉0. 05）. The complication rate of study group was lower than that of control group（ P〈0. 05）.The palmar tilt in study group 3 months after treatment was better than that in control group（ P〈0. 05）,and the palmar tilt and radial height in study group 12 months after treatment were better than those in control group（ P〈0. 05）. Dienst grades in study group three months after treatment was better than that in control group（ P〈0. 05）. There were significant differences in scores of PRWE and SAS betweent study group and control group 3 months and 12 months after treatment（ P〈0. 05）;Conclusions Volar variable-angle locking plate is effective in improving the quality of life in the elderly patients with distal radius fractures.