斜T型锁定加压钛板内固定治疗桡骨远端骨折的疗效评价

Evaluation of the therapeutic effect of LCP oblique T-shaped titanium plate internal fixation on patients with distal radius fractures

目的探究斜T型锁定加压钛板(Locking compression plate,LCP)内固定治疗桡骨远端骨折(Distal radius fracture,DRF)患者的效果。方法回顾性分析2022年1月-2023年1月收治的100例DRF患者的病例资料,按手术方案不同分两组。以接受斜T型LCP内固定治疗的50例为A组,以接受传统钢板内固定(Ordinary steel plate internal fixation,OSPIF)治疗的50例为B组。对比两组手术前后Cooney腕关节评分、影像学指标、手术指标、骨代谢[护骨素(OPG)、核因子κB受体活化因子(RANK)、RANK配体(RANKL)]水平、并发症发生率。结果A组术后3个月握力、功能、疼痛、活动范围、伸展/屈曲活动度评分相较于B组更高(P<0.05);A组术后3个月桡腕关节面平整度、掌倾角相较于B组更低,桡骨高度、尺偏角相较于B组更高(P<0.05);A组手术及住院用时、术中失血量相较于B组差异无统计学意义(P>0.05);A组术后3个月血清OPG水平相较于B组更高,血清RANK、RANKL水平相较于B组更低(P<0.05);A组并发症发生率2.00%(1/50)相较于B组16.00%(8/50)更低(P<0.05)。结论相较于OSPIF治疗DRF患者,经斜T型LCP内固定治疗更有助于减少并发症,改善腕关节功能,促进解剖复位,加速骨折愈合。

Objective To investigate the effectiveness of locking compression titanium plate(LCP)oblique T-shaped titanium plate internal fixation in the treatment of patients with distal radius fractures(DRF).Methods Retrospective collection of case data from 100 DRF patients in our hospital(January 2022 to January 2023),divided into two groups according to different surgical plans.50 patients who received LCP oblique T-shaped titanium plate internal fixation treatment were classified as Group A,and 50 patients who received traditional steel plate internal fixation(OSPIF)treatment were classified as Group B.Compared the Cooney wrist joint score,imaging indicators,surgical indicators,bone metabolism[Osteoprotegerin(OPG),Nuclear factor]between two groups before and after surgeryκB receptor activating factor(RANK),RANK ligand(RANKL)levels,and incidence of complications.Results The scores of grip strength,function,pain,range of motion,and extension/flexion range of motion in Group A were higher than those in Group B 3 months after surgery(P<0.05);Three months after surgery,the flatness and palm angle of the radiocarpal joint surface in Group A were lower than those in Group B,while the radius height and ulnar deviation angle were higher than those in Group B(P<0.05);There was no significant difference in surgical and hospitalization time and intraoperative blood loss between Group A and Group B(P>0.05);Three months after surgery,the serum OPG levels in Group A were higher than those in Group B,and the serum RANK and RANKL levels were lower than those in Group B(P<0.05);The incidence of complications in Group A was 2.00%(1/50),which was lower than Group B's 16.00%(8/50)(P<0.05).Conclusion Compared to OSPIF treatment for DRF patients,LCP oblique T-shaped titanium plate internal fixation treatment is more helpful in reducing complications,improving wrist joint function,promoting anatomical reduction,and accelerating fracture healing.