不同类型桡骨远端Die-punch骨折的治疗效果对比研究

Comparative Study on the Therapeutic Effect of Different Types of Diepunch Fractures of the Distal Radius

目的探讨不同类型桡骨远端Die-punch骨折的治疗效果。方法回顾性分析该院骨科2013年1月—2017年9月60例桡骨远端Die-punch骨折患者,其中11例为背侧型,3例为掌侧型,19例为劈裂性,21例为塌陷型,6例为塌陷伴劈裂型。42例患者的骨折存在移位现象,18例患者未存在移位现象。在所有存在移位现象患者中共有37例患者予以手术复位治疗,其余患者予以非手术治疗治疗。观察患者的骨折愈合优良率、骨折愈合时间与不良反应的发生情况。结果术后对患者进行为期4年的随访,患者的骨折情况较好,其中出现3例不良反应,主要表现为创伤性腕关节炎,并且有1例患者因类型为塌陷伴劈裂治疗效果不满意;未存在移位现象的患者的骨折愈合优良率明显高于存在移位现象患者;塌陷型与塌陷伴劈裂型患者的骨折愈合优良率为44.44%,明显低于其他类型的75.76%,差异有统计学意义(χ~2=6.160,P<0.05);手术治疗组与非手术组的骨折愈合优良率分别为86.49%与69.57%,差异无统计学意义(χ~2=2.538,P>0.05)。结论不同类型桡骨远端Die-punch骨折的治疗具有不同效果,塌陷型与塌陷伴劈裂型不仅是最严重类型,同时也是引起患者不良反应的主要类型,进而延缓患者的骨折愈合时间。

Objective This paper tries to explore the different types of Die-punch distal radius fractures.Methods A retrospective analysis of this hospital department of orthopedics from January 2013 to September 2017 of 60 cases of distal radius fractures in patients with Die-punch,including 11 cases of dorsal type,3 cases of palmar type,19 cases were split,21 case were collapse type,and 6case were collapes with cleft.Patients with type 42 fracture patients with fracture displacement phenomenon of collapse,18 patients did not exist in the translocation phenomenon.All existing shift phenomenon of patients with a total of 37 patients received surgery reduction treatment,the rest of the patients to be non observed in patients with treatment of surgery.The excellent rate of healing fractures,fracture healing and adverse reaction time.Results After the operation for a period of four years of follow-up of patients,patients with better fracture,including 3 cases of adverse reactions,mainly for traumatic arthritis,and 1 patients with type with fracturing treatment is not satisfactory collapse;shift phenomenon did not exist in patients with fracture healing rate was significantly higher than that of existing shift patients;collapse and collapse with split type of patients with fracture healing was 44.44%,significantly lower than the other 75.76%types,the difference is Statistical significance(χ2=6.160,P<0.05);excellent healing rate of surgical treatment group and non operation group were 86.49%and 69.57%of the fractures,was not statistically significant(χ2=2.538,P>0.05).Conclusion The treatment of distal radius fractures of different types of Die-punch have different effects,collapse type with the splitting and collapse type is not only the most serious type,but also caused the main types of adverse reactions in patients,and patients with delayed fracture healing time.