桡骨远端AO万向锁定钢板和普通锁定钢板治疗老年AO-C型桡骨远端骨折的疗效比较

Comparison of the efficacy between distal radius AO universal locking plate and ordinary locking plate in the treatment of elderly AO-C type distal radius fractures

目的探讨桡骨远端AO万向锁定钢板和普通锁定钢板对老年AO-C型桡骨远端骨折的疗效。方法老年AO-C型桡骨远端骨折患者206例,按非随机同期对照试验方法分为研究组(n=95)和对照组(n=111)。对照组予以普通锁定钢板内固定术,研究组予以AO万向锁定钢板内固定术。观察两组术后恢复情况,术后并发症发生情况。比较两组术后1个月血液流变学指标水平和骨代谢标志物水平,对比两组术后6个月上肢功能水平。结果两组住院时间、患肢肿胀消退时间、疼痛消失时间、术后并发症发生情况比较,差异无统计学意义(P>0.05)。术后1个月,两组血液流变学指标水平低于治疗前,且研究组低于对照组(P<0.05);研究组骨代谢标志物水平高于对照组(P<0.05)。术后6个月,研究组腕关节活动度、握力水平高于对照组,Gartland-Werley与DASH评分低于对照组(P<0.05)。结论对老年AO-C型桡骨远端骨折采用桡骨远端AO万向锁定钢板内固定术干预临床效果更佳,可以提高术后骨愈合效率,帮助上肢功能恢复。

Objective To explore the efficacy of AO universal locking plate of distal radius and ordinary locking plate in the treatment of elderly AO-C type distal radius fractures.Methods A total of 206 elderly patients with AO-C distal radius fractures treated in the Sichuan Provincial Orthopedic Hospital were selected.The patients were divided into a study group(n=95)and a control group(n=111)according to the non-randomized concurrent controlled trial.The control group received ordinary locking plate internal fixation,and the study group was given AO universal locking plate internal fixation.The postoperative recovery status was observed and the occurrence of postoperative complications was recorded in the two groups.The levels of hemorheological indicators after 1 month of surgery,the levels of bone metabolism markers after 1 month of surgery and the upper limb function after 6 months of surgery were compared between the two groups.Results There were no statistically significant differences in the hospital stay,the time to disappearance of affected limb swelling,the time to disappearance of pain and occurrence of postoperative complications between the two groups(P>0.05).After 1 month of surgery,the levels of hemorheological indicators of the two groups were significantly lower than those before treatment,and the study group was significantly lower than the control group(P<0.05).The levels of bone metabolism markers of the study group were significantly higher than those of the control group(P<0.05).After 6 months of surgery,the range of wrist motion and grip strength were significantly higher in the study group than those in the control group while the Gartland-Werley score and DASH score were significantly lower than those in control group(P<0.05).Conclusion AO universal locking plate internal fixation of distal radius has a better clinical effect in the treatment of elderly AO-C type distal radius fractures.It can enhance the efficiency of postoperative bone healing and help the recovery of upper limb function.