万向锁定接骨板与普通钢板治疗老年桡骨远端AO-C型骨折的疗效比较

Therapeutic Effect of Universal Locking Plate and Common Plate in Treating AO - C Fracture of the Distal Radius

目的：比较万向锁定接骨板与普通钢板治疗老年桡骨远端AO-C型骨折的疗效。方法：2013年9月～2016年9月，我科收治老年桡骨远端A0-C型骨折患者48例。男29例，女19例；平均年龄63.6±7.2岁；按照AO/OTA分型：C1型20例，C2型18例，C3型10例。其中26例患者采用万向锁定接骨板治疗作为观察组;22例患者采用普通钢板治疗作为对照组。比较2组患者术前，术后6个月时掌倾角、尺偏角、桡骨高度；比较2组患者术后6个月时腕关节背伸、掌屈、旋前、旋后角度;依据腕关节Gartland-Werley评分标准评价2组患者术后6个月关节功能。结果：术后所有患者均获6～14个月（平均9.7个月）随访。观察组和对照组患者骨折愈合时间分别为8～11周（平均9.2周）和8～15周（平均11.6周）。术后6个月2组患者掌倾角、尺偏角、桡骨高度较术前均明显恢复,差异有统计学意义（P〈0.05）;相较于对照组,观察组术后6个月掌倾角、尺偏资、桡骨高度优于对照组，差异有统计学意义（P〈0.05）;.术后6个月时观察组腕关节背伸、掌屈、旋前、旋后角度优于对照组，差异有统计学意义（P〈0.05）;术后6个月腕关节Gartland-Werley评分，观察组优良率高于对照组，差异有统计学意义（P〈0.05）。结论：万向锁定接骨板治疗老年桡骨远端AO-C型骨折，固定牢靠，运动功能恢复快，疗效满意。

Objective： To compare the effect of universal locking plate and common plate in the treatment of AO -C distal radius frac- tures in the elderly. Methods： From September 2013 to September 2016, 48 cases of AO - C fractures in the distal radius of the elderly were treated in our department. There were 29 males and 19 females with a mean age of（63.6±7.2） years. According to AO / OTA clas- sification, there were 20 cases of type C1, 18 cases of type C2 and 10 cases of type C3. Among them, 26 patients were treated with uni- versal locking plate, as the study group; 22 patients were treated with anatomical plate as the control group. The inclination, ulnar angle and radius height of the two groups were compared before and 6 months after operation. Wrist dorsiflexion, palmar flexion, pronation and supination angle were compared between the two groups at 6 months after operation. The joint function of the two groups was evaluated at 6 months after surgery according to the Gartland -Werley score of the wris. Results： All patients were followed up for 6 to 14 months（ av- erage 9.7 months）. Fracture healing time in observation group and control group were 8 to 11 weeks（ average 9.2 weeks）and 8 to 15 weeks（average 11.6 weeks）, respectively. At 6 months after operation, the inclination, ulnar angle and radius height of the two groups were significantly recovered compared with that before operation, with significant difference（P 〈0.05）. Palmar inclination, ulnar devia- tion angle and radius height of the observation group at 6 months after operation were better than those in the control group, with significant difference （ P 〈 0.05 ）. The angle of dorsiflexion, palmar flexion, pronation and pronation of the wrist at 6 months postoperatively in the observation group was better than that of the control group, with significant difference （ P 〈 0.05 ）. The Gartland - Werley score of the wrist joint at 6 months postoperatively was higher in the observation group than in the control group, with significant difference （ P 〈 0. 05 ）. Conclusions： The locking plate fixation for the treatment of AO - C fractures in the distal radius of the elderly is reliable, with fast recovery of motor function.