C型桡骨远端骨折三种内固定术治疗疗效及腕关节功能恢复情况随访结果比较

Comparison of the efficacy of three kinds of internal fixation methodsin the treatment of type C distal radius fractures and the follow-up of wrist joint functional recovery

目的:探讨三种内固定术对C型桡骨远端骨折患者疗效及腕关节功能恢复情况的影响差异。方法:回顾性分析2011年5月~2016年5月于我院行闭合复位经皮克氏针内固定术(A组,n=26)、掌侧Henry入路切开复位内固定术(B组,n=28)和背侧入路切开复位内固定术(C组,n=26)的共计80例C型桡骨远端骨折患者临床资料。比较三组受试者随访6个月、12个月时腕关节功能(腕关节功能Cooney评分表)优良率及治疗前、随访期间桡骨远端掌倾角、尺偏角及腕关节活动度检测结果变化情况,记录其并发症发生率差异。结果:三组受试者并发症发生率比较均无显著性。随访期间,三组受试者腕关节功能优良率比较均无显著性,但同组受试者随访12个月时腕关节优良率均明显优于随访6个月时,差异均有显著性。随访6个月、12个月时,三组受试者桡骨远端掌倾角、尺偏角检测结果及腕关节活动度均较治疗前明显提高,差异有显著性,但组间比较无显著性。结论:三种内固定术式均在C型桃谷远端骨折中具有较高应用价值,实际应用时可根据具体情况选择最佳术式,为患者获得理想的远期预后效果提供条件。

Objective To investigate the efficacy of three kinds of internal fixation methods in the treatment of type C distal radius fractures and the effect on wrist joint functional recovery. Methods The clinical data of 80 patients with type C distal radius fractures who were treated by closed reduction and percutaneous Kirschner wire fixation(group A, n=26), volar Henry approach open reduction and internal fixation(group B, n=28) and dorsal approach open reduction and internal fixation(group C, n=26) in the hospital between May 2011 and May 2016 were retrospectively analyzed. The excellent and good rates of wrist joint function(Cooney wrist function score) after 6 months and 12 months of follow-up, the radius distal palmar tilt and ulnar deviation during follow-up and changes of wrist range of motion were compared among the three groups, and incidence of postoperative complications were recorded. Results There were no significant differences in incidence rates of related complications between the three groups. During the follow-up, there was no significant difference in the excellent and good rate of wrist joint function among the three groups. The excellent and good ratesof wrist joint function in the same group after 12 months of followup were significantly better than after 6 months of follow-up. After 6 months and 12 months of follow-up, the radius distal palmar tilt, ulnar deviation and wrist range of motionwere significantly improved, compared with those before treatment, but there were no significant differences among groups. Conclusion All of the three kinds of internal fixation methodsare of high application value in type C distal radiusfractures. In actual application, the method can be chosen according to the specific condition, providing the basis for long-term ideal prognosis.