掌侧锁定加压钢板治疗老年桡骨远端C1、C2型骨折的临床疗效分析

Effect of volar locking compression plate on C1 and C2 fractures in the distal radius of the elderly

目的探讨掌侧锁定加压钢板(LCP)治疗老年桡骨远端C1、C2型不稳定型骨折的效果。方法选取我院收治的80例桡骨远端C1、C2型不稳定型骨折老年患者进行回顾性分析,其中40例患者采用掌侧LCP内固定治疗(研究组)、另外40例患者采用外固定支架固定治疗(对照组);对比2组的手术时间、出血量、骨折愈合时间,术后3个月2组患者的掌倾角、尺偏角、桡骨缩短、关节面位移、Cooney腕关节功能评分。结果研究组的手术时间、出血量均显著高于对照组(P<0.05),研究组患者的骨折愈合时间与对照组差异无统计学意义(P>0.05);术后3个月,研究组的掌倾角、尺偏角、桡骨缩短与对照组比较,差异无统计学意义(P>0.05),研究组患者的关节面位移显著低于对照组,差异具有统计学意义(P<0.05);术后3个月,研究组的的腕关节功能评价与对照组比较,差异具有统计学意义(P<0.05),研究组优于对照组。结论掌侧LCP治疗老年桡骨远端C1、C2型不稳定型骨折有利于早期功能锻炼,对于早期患者腕关节功能恢复有一定价值。

Objective To investigate the effect of volar locking compression plate (LCP) on the treatment of unstable C1 and C2 fractures in the distal radius of the elderly.Methods A retrospective analysis of 80 elderly patients with unstable C1 and C2 fractures of the distal radius was performed in our hospital.A total of 40 patients (study group) were treated with volar LCP internal fixation and another 40 patients (control group) were fixed with external fixation.The operation time,the amount of bleeding,the time of fracture healing,and the paw inclination angle,the ulnar angle,the shortening of the tibia,the displacement of the joint surface and the Cooney wrist function score 3 months after operation were compared between the two groups.Results The operation time and blood loss of the study group were significantly higher than those of the control group (P<0.05).There was no significant difference in the fracture healing time between the study group and the control group (P>0.05).There was no significant difference between the palm tilt angle,the ulnar angle and the tibia shortening compared with the control group (P>0.05).The joint surface displacement of the study group was significantly lower than that of the control group,the difference was statistically significant (P<0.05).In the last 3 months,the wrist function evaluation of the study group was statistically significant compared with the control group (P<0.05),and the study group was superior to the control group.Conclusion The volar LCP treatment of unstable distal C1 and C2 fractures in the elderly is beneficial to early functional exercise and has certain value for the recovery of wrist function in early patients.