超腕小夹板固定治疗老年骨质疏松性桡骨远端骨折的效果

Effect of super-small splint fixation in the treatment of senile osteoporotic distal radius fracture

目的探讨超腕小夹板固定治疗老年骨质疏松性桡骨远端骨折的效果。方法回顾性分析2016年5月~2018年5月我院收治的105例老年骨质疏松性桡骨远端骨折患者的临床资料,按照治疗方法的不同将其分为超腕小夹板固定组(n=54)和石膏固定组(n=51)。两组治疗后随访3个月,比较两组的腕关节功能和骨密度。结果超腕小夹板固定组的改良Mcbridge腕关节评分标准及Sanniento影像学评分优良率为74.1%和87.0%,高于石膏固定组的51.0%和72.5%,差异均有统计学意义(P<0.05)。随访3个月后比较两组的X线平片资料,小夹板组的掌倾角、尺偏角、尺桡骨间距均大于石膏组,差异有统计学意义(P<0.05)。比较治疗前及治疗3个月后骨密度值变化,超腕小夹板固定组骨密度值变化小于石膏固定组,差异有统计学意义(P<0.05)。结论超腕小夹板固定治疗老年患者骨质疏松性桡骨远端骨折的临床效果优于石膏外固定法,应在临床加以推广。

Objective To investigate the effect of super-wrist splinting in the treatment of elderly patients with osteoporotic distal radius fracture. Methods The clinical data of 105 elderly patients with osteoporotic distal radius fractures admitted to our hospital from May 2016 to May 2018 were retrospectively analyzed. According to different treatment methods, they were divided into super-wrist splint fixation group(n=54) and the cast group(n=51), the two groups of patients were followed up for 3 months after treatment, the wrist function and bone density of the two patients were compared. Results The improved Mcbridge wrist scores and Sannento imaging scores were 74.1% and 87.0% in the super-cleft splint-fixed group, both were higher than the plaster-fixed group of 51.0% and 72.5%, and the differences were statistically significant(P<0.05). After 3 months of follow-up, the X-ray plain film data of the small splint group and the gypsum group were compared. The difference of the palm tilt angle, the ulnar angle and the ulnar and radial bone spacing of the small splint group were larger than that of the gypsum group, and the differences were statistically significant(P<0.05). The changes of bone mineral density before treatment and after 3 months of treatment were compared. The change of bone mineral density in the super-wrist splint fixation group was smaller than that in the plasterfixed group, and the difference was statistically significant(P <0.05). Conclusion The clinical effect of super-small splint fixation in the treatment of osteoporotic distal radius fractures in elderly patients is superior to the external fixation of gypsum, and should be promoted and applied in the clinical of brittle fractures of the distal radius.