闭合复位与切开复位内固定术治疗桡骨远端骨折对比研究

Comparative study on closed reduction or open reduction and internal fixation in treatment of distal radius fracture

目的研究闭合复位与切开复位内固定术治疗桡骨远端骨折的临床效果。方法选取桡骨远端骨折患者72例,采用随机数字表法将所选患者分为对照组与观察组,各36例。对照组行闭合复位内固定术治疗,观察组行切开复位内固定术治疗。对比两组手术指标、掌倾角、尺偏角、桡骨长度以及并发症发生情况。结果观察组手术时间(63.43±2.06)min及出血量(62.79±13.14)ml均较对照组高,差异具有统计学意义(P<0.05);两组骨折愈合时间比较,差异无统计学意义;治疗后,观察组掌倾角(8.01±4.62)°、尺偏角(21.24±5.71)°、桡骨长度(9.67±0.25)mm明显较对照组大,差异具有统计学意义(P<0.05);观察组固定松脱、钉道感染、钉道渗液等并发症总发生率(16.67%)略高于对照组(8.33%),但差异无统计学意义。结论切开复位内固定术用于治疗桡骨远端骨折更有助于促进患者术后腕关节功能的恢复,且安全性较好。

Objective To study the clinical effects of closed reduction and internal fixation（CRIF） or open reduction and internal fixation（ORIF） in treatment of distal radius fracture. Methods 72 patients with distal radius fracture from March 2015 to March 2016 were divided into control group and observation group by random number table, 36 cases in each group. Control group was given CRIF, while observation group was treated with ORIF. The surgical indexes, palm tilt, ulnar inclination, length of radius, complications were compared between the two groups. Results The operation time and bleeding volume in observation group [（63.43±2.06）min,（62.79±13.14）ml] were higher than those in control group（P〈0.05）;there was no statistical difference in the fracture healing time between the two groups; after treatment, the palm tilt, ulnar inclination, length of radius in observation group [（8.01±4.62）°,（21.24±5.71）°,（9.67±0.25）mm] were larger than those in control group（P〈0.05）; the total incidence of loose fixation, pin track infection, pin track effussion in observation group（16.67%） was slightly higher than control group（8.33%）, but there was no statistical difference. Conclusion ORIF in treatment of distal radius fracture can promote recovery of wrist joint and have better safety.