切开复位掌侧锁定钢板内固定与闭合复位石膏外固定治疗桡骨远端粉碎性骨折临床比较

Clinical Comparison of Open Reduction Palmar Locking Plate Internal Fixation and Closed Reduction Plaster External Fixation in Treatment of Comminuted Distal Radius Fractures

目的:比较切开复位掌侧锁定钢板内固定与闭合复位石膏外固定治疗桡骨远端粉碎性骨折临床效果。方法:选择2017年10月-2019年10月笔者所在医院治疗的82例桡骨远端粉碎性骨折患者,按随机数字表法将其分为两组,各41例。对照组采用闭合复位石膏外固定治疗,观察组采用切开复位掌侧锁定钢板内固定治疗。比较两组腕关节功能、尺偏角及掌倾角、并发症及骨折愈合时间。结果:观察组腕关节功能恢复优良率(95.12%)高于对照组(75.61%),并发症发生率(12.20%)低于对照组(39.02%),差异有统计学意义(P<0.05);观察组治疗后尺偏角、掌倾角分别为(20.37±1.58)°、(10.52±3.15)°,均大于对照组的(18.26±1.89)°、(8.56±2.39)°,差异有统计学意义(P<0.05);观察组骨折愈合时间为(12.17±2.93)周,对照组骨折愈合时间为(11.94±2.78)周,比较差异无统计学意义(P>0.05)。结论:切开复位掌侧锁定钢板内固定有利于促使桡骨远端粉碎性骨折患者腕关节功能的恢复,且并发症少,但基于手术治疗风险大于保守治疗,故应依据患者自身需求及身体条件选取更为适宜的治疗方法。

Objective:To compare the clinical effects of open reduction palmar locking plate internal fixation and closed reduction plaster external fixation in the treatment of comminuted distal radius fractures.Method:Eighty-two patients with comminuted fractures of the distal radius treated in our hospital from October 2017 to October 2019 were selected and divided into two groups with a random number table method,41 cases in each.The control group was treated with closed reduction and plaster external fixation,and the observation group was treated with open reduction and palmar locking plate internal fixation.The wrist joint function,ulnar deviation angle and palm inclination angle,complications and fracture healing time were compared between the two groups.Result:The excellent rate of wrist joint function recovery in the observation group(95.12%)was higher than 75.61%in the control group,and the incidence of complications(12.20%)was lower than 39.02%in the control group,the difference was statistically significant(P<0.05).The ulnar deflection angle and palm angle of the observation group after treatment were(20.37±1.58)°and(10.52±3.15)°,which were greater than those of the control group(18.26±1.89)°and(8.56±2.39)°,the differences were statistically significant(P<0.05).The fracture healing time of the observation group was(12.17±2.93)weeks,and the fracture healing time of the control group was(11.94±2.78)weeks,there was no significant difference between the two groups(P>0.05).Conclusion:The open reduction and internal fixation of the palmar locking plate are beneficial to promote the recovery of wrist function in patients with comminuted distal radius fractures,and there are few complications,but the risk of surgical treatment is greater than conservative treatment,so it should be selected more suitable treatment according to the patients’own needs and physical conditions.