低切迹三叉戟桡骨远端锁定板治疗老年桡骨远端C型骨折的临床观察

Clinical observation of trident distal radius locking plate with low profile in the treatment of type C fracture of distal radius in the elderly

目的 观察三叉戟桡骨远端锁定钢板治疗老年桡骨远端C型骨折的临床疗效。方法 选取2014年1月至2017年1月本院收治的58例老年骨质疏松性桡骨远端C型骨折患者作为研究对象,根据手术方法不同分为对照组(n=31)和观察组(n=27)。对照组采用动态外固定支架联合克氏针手术治疗,观察组采用三叉戟桡骨远端锁定钢板内固定手术治疗,比较两组掌倾角、尺偏角、桡骨高度、视觉模拟评分法(VAS)评分、上肢功能(DASH)评分、腕关节功能Garland-Werley评分。结果 术后即刻、术后3个月及末次回访,两组掌倾角、尺偏角和桡骨高度比较差异均无统计学意义;末次回访时,两组VAS评分、DASH评分比较差异无统计学意义;观察组Garland-Werley评分低于对照组(P<0.05)。结论 老年患者的桡骨远端C型骨折采用早期的三叉戟桡骨远端锁定钢板切开复位内固定能获得较好的稳定性和早期的功能锻炼,临床疗效优于动态外固定支架联合克氏针治疗。

Objective To observe the clinical effect of the trident distal radius locking plate with low profile in the treatment of the elderly distal C-type fracture. Methods A total of 58 elderly patients with osteoporotic C-type fracture of the distal radius treated in our hospital from January 2014 to January 2017 were selected as the study subjects, and they were divided into control group(n=31) and observation group(n=27) according to different surgical methods. The control group was treated with dynamic external fixation stent combined with Kirschner wire operation, and the observation group was treated with trident volar plate internal fixation operation. The palm inclination, ulnar declination, radial height, visual analogue scale(VAS) score, upper extremity function(DASH) score, and Garland-Werley score of wrist joint function were compared between the two groups. Results Immediately after the operation, 3 month after the operation and the last follow-up visit, there was no significant difference in the palmar inclination, ulnar declination and radial height between the two groups. At the last return visit, there was no significant difference in the VAS score and DASH score between the two groups;the Garland-Werley score in the observation group was lower than that in the control group(P<0.05). Conclusion In elderly patients with C-type fracture, the use of early trident distal radius locking plate open reduction and internal fixation can achieve better stability and early functional exercise, and the clinical efficacy is better than dynamic external fixation stent combined with Kirschner wire treatment.