两种治疗方案对老年人桡骨远端骨折的疗效比较

Evaluation of the efficacy of two regimens in the treatment of distal radius fractures in the elderly

目的:探讨采用保守治疗和切开复位内固定两种方案对65岁以上老年人桡骨远端骨折(DRF)的疗效。方法:选择我院于2020年6月—2022年2月收治的DRF患者81例,分为手法组(46例)与切开组(35例)。手法组采用骨折手法复位高分子聚酯绷带固定治疗;切开组采用切开复位内固定手术治疗。使用X线片对比患者治疗前后的尺偏角、掌偏角和桡骨高度,以评估治疗情况。统计患者末次随访的改良Mayo腕关节评分(MMWS)、DASH-Chinese上肢功能评分以及并发症,对患者预后评价。结果:两组治疗后尺偏角、掌偏角和桡骨高度较治疗前增加(P<0.05);切开组治疗后尺偏角、掌偏角和桡骨高度高于手法组(P<0.05)。两组治疗后MMWS较治疗前增加,而DASH-Chinese上肢功能评分较治疗前降低(P<0.05);切开组治疗后MMWS高于手法组,而DASH-Chinese上肢功能评分低于手法组(P<0.05)。切开组并发症发生率低于手法组(P<0.05)。结论:切开复位内固定术治疗老年人DRF有明显的临床优势,可以促进患者腕关节和上肢功能恢复。

Objective To explore the effects of conservative treatment and open reduction with internal fixation on the quality of life and therapeutic effect of the elderly over 65 years old.Methods The 81 patients with distal radius fractures in our hospital from June 2020 to February 2022 were selected and divided into a manual group(46 cases)and an incision group(35 cases).The manipulation group was treated with fracture reduction and high polymer polyester bandage fixation;the incision group was treated with open reduction and internal fixation surgery.X-ray films were used to compare the ulnar deviation,palmar deviation and radius height before and after treatment.To assess treatment.The modified Mayo wrist score(MMWS),DASH-Chinese upper limb function score and the incidence of complications in the last follow-up were counted to evaluate the prognosis of the patients.Results After treatment,the ulnar deviation angle,palmar deviation angle,and radius height of the two groups increased compared to before treatment(P<0.05);after treatment,the ulnar deviation angle,palmar deviation angle,and radius height in incision group were higher than those in manipulation group(P<0.05).After treatment,the MMWS of the two groups increased compared to before treatment,while the DASH-Chinese upper limb function score decreased compared to before treatment(P<0.05);after treatment,the MMWS of incision group was higher than that of manipulation group,while the DASH-Chinese upper limb function score was lower than that of manipulation group(P<0.05).The incidence of complications in group B was lower than that in manipulation group(P<0.05).Conclusion The results of this study show that open reduction and internal fixation has obvious clinical advantages in the treatment of distal radius fractures in the elderly,and can promote the recovery of wrist and upper limb function.