桡骨远端粉碎性骨折患者单臂外固定架结合微创手术治疗的效果及对关节功能的影响

Effect of Single Arm External Fixator Combined with Minimally Invasive Surgery on Joint Function in Patients with Comminuted Distal Radius Fracture

目的观察并分析对桡骨远端粉碎性骨折患者应用单臂外固定架结合微创手术的治疗效果。方法选取2020年1月—2022年6月南通市崇川区港闸医院手足外科收治的50例桡骨远端粉碎性骨折患者为研究对象,采用阿拉伯数字分配法,列出流水号为1~50所对应的治疗分配表进行分组处理(观察组和对照组)。对照组(n=25)和观察组(n=25)分别给予切开复位钢板内固定、单臂外固定架结合微创手术治疗。对比两患者组治疗有效率、关节功能以及并发症发生率。结果治疗1年后,观察组治疗总有效率为96.00%,稍高于对照组80.00%,差异无统计学意义(χ^(2)=1.705,P>0.05)。经试验结果可知,观察组患者关节功能状态均优于对照组,差异有统计学意义(P<0.05)。两组并发症发生率对比,差异无统计学意义(χ^(2)=0.664,P>0.05),但观察组关节炎、关节僵硬、钉道感染以及神经损伤发生率均稍低于对照组。结论相较于切开复位钢板内固定术,对桡骨远端粉碎性骨折患者应用单臂外固定架结合微创手术,可更好地改善其关节功能状态,且安全性尚可,并发症较少,可行性良好。

Objective To observe and analyze the effect of single arm external fixator combined with minimally invasive surgery on patients with comminuted distal radius fracture.Methods From January 2020 to June 2022,50 patients with comminted distal radius fractures admitted to the Department of Hand and Foot Surgery in Chongchuan District Gangzha Hospital were selected as research subjects.The treatment assignment tables corresponding to serial numbers 1~50 were listed using the Arabic numerical allocation method for grouping treatment(observation group and control group).Control group(n=25)and observation group(n=25)were respectively treated with open reduction plate internal fixation,single-arm external fixator combined with minimally invasive surgery.The effective rate,joint function and complication rate of the two groups were compared.Results After 1 year of treatment,the total effective rate of the observation group was 96.00%,slightly higher than that of the control group 80.00%,while there was no statistically significant difference between the two groups(χ^(2)=1.705,P>0.05).The experimental results showed that the joint function status of patients in the observation group was better than that in the control group,and the difference was statistically significant(P<0.05).The incidence of complications between the two groups was compared,while there was no statistically significant difference between the two groups(χ^(2)=0.664,P>0.05),but the incidence of arthritis,joint stiffness,nail tract infection and nerve injury in the observation group were slightly lower than those in the control group.Conclusion Compared with open reduction plate internal fixation,the application of single arm external fixator combined with minimally invasive surgery for patients with comminuted distal radius fractures can better improve their joint function status,and it is safe,with fewer complications and good feasibility.