两种方法治疗背侧型Barton骨折的临床疗效比较

Clinical Study of Two Therapeutic Methods for Dorsal Barton Fracture

目的探讨手法复位外固定架固定和桡背侧入路切开复位内固定2种方法治疗背侧型Barton骨折的疗效.方法选取54例背侧型Barton骨折患者随机分为治疗组(n=31例)和对照组(n=23例).分别采用手法复位外固定架固定术和桡背侧入路切开复位钢板内固定术.术后定期随访、摄片、指导康复锻炼,对术后6个月腕关节功能、术后1个月骨折解剖复位情况进行评价,比较2种方法的治疗效果.结果术后1个月骨折复位情况治疗组及对照组的优良率分别为90.3%、91.3%,2组差异无统计学意义(P>0.05);术后6个月腕关节功能恢复情况优良率分别为93.5%、86.9%,2组比较差异有统计学意义(P<0.05).结论应用手法复位外固定架固定术与桡背侧入路切开复位钢板内固定术治疗背侧型Barton骨折均可达到满意疗效,但应用手法复位外固定架治疗,可早期功能锻炼,对腕关节功能恢复更好.

Objective To investigate the effects of manipulative reduction and external fixation and dorsalapproach(Thompson)of radius open reduction and internal fixation in the treatment of dorsal Barton fractures.Methods Fifty-four cases of dorsal Barton fractures were randomly divided into treatment group(n=31cases)and control group(n=23cases),and received manipulative reduction and external fixation and dorsal approach(Thompson)of radius open reduction and internal fixation respectively.Patients were given regular follow-up afteroperation,photographs,and guidance of rehabilitation exercise.The effects of the two therapeutic methods werecompared by evaluating wrist joint function6months after the operation and anatomic reduction status1months afterthe operation.Results For anatomic reduction status1months after the operation,the results were excellent in90.3%of the treatment group and91.3%of the control group.There was no significant difference between the twogroups(P>0.05).For wrist joint function6months after the operation,the results were excellent in93.5%of thetreatment group and86.9%of the control group.There were statistically significant differences between the two groups(P<0.05).Conclusions Both manipulative reduction and external fixation and dorsal approach(Thompson)of radius open reduction and plate internal fixation can achieve satisfactory curative effect.However,manualreduction and external fixation is better for early functional exercise and functional rehabilitation of wrist joint.