多向锁定加压钢板与外固定支架在C型桡骨远端骨折治疗中的效果比较

Comparison the effect of multi-directional locking compression plate and external fixator in the treatment of C-type distal radius fracture

目的比较多向锁定加压钢板与外固定支架在C型桡骨远端骨折治疗中的效果,为C型桡骨远端骨折手术方案的选择提供依据。方法选择2014年9月至2016年7月住院治疗的86例C型桡骨远端骨折患者作为研究对象,按照手术治疗的时间顺序分为对照组和观察组,各43例。观察组采用多向锁定加压掌侧双柱接骨板治疗,对照组采用外固定支架治疗。分析两组患者骨折愈合情况、腕关节功能恢复情况和掌倾角、尺偏角、桡骨高度。结果两组患者术后骨愈合时间无显著差异(P>0.05);对照组患者愈合良好率为100.00%,高于观察组的97.67%,但差异无统计学意义(P>0.05)。术后18个月,两组患者的掌倾角、尺偏角和桡骨高度均显著改善(P<0.05),但组间比较,差异无统计学意义(P>0.05)。术后6个月,观察组患者Garland-werly评分明显低于对照组(P<0.05);术后18个月,两组患者Garland-werly评分无显著差异(P>0.05)。结论在桡骨远端C型骨折治疗中,两种方式均可获得良好的疗效,多向锁定加压掌侧双柱接骨板治疗的短期疗效更有优势。

Objective To compare the effect of multi-directional locking compression plate and external fixator in the treatment of C-type distal radius fracture, so as to provide a reference for the selection of operative scheme of C-type distal radius fracture. Methods From September 2014 to July 2016, 86 patients who hospitalized with C-type distal radius fracture were selected as the study objects. According to the time sequence of surgical treatment, the patients were divided into control group and observation group, with 43 cases in each group. The observation group was treated with multi-directional locking compression volar double-column plate, while the control group was treated with external fixator. The fracture healing, wrist function recovery, palm inclination angle, ulnar deviation angle and radius height of the two groups were analyzed. Results There was no significant difference in bone healing time after operation between the two groups(P >0. 05);the good healing rate of patients in the control group was 100.00%, which was higher than 97.67% of the observation group, but the difference was not statistically significant(P >0.05). At 18 months after operation, the palm inclination angle, ulnar deviation angle and radius height of the two groups improved significantly(P<0.05), but there were no significant differences between the two groups(P>0.05). At 6 months after operation, the Garland-werly score of the observation group was significantly lower than that of the control group(P<0.05);while at 18 months after operation, there was no significant difference in Garland-werly score between the two groups( P>0.05). Conclusion In the treatment of C-type distal radius fracture, both methods can obtain good results, and the short-term effect of multi-directional locking compression palmar double-column plate is more advantageous.