外固定支架与切开复位内固定术对老年不稳定性桡骨远端骨折的疗效及对腕关节功能的影响

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摘要目的探讨不稳定性桡骨远端骨折老年患者分别应用外固定支架联合小夹板外固定与切开复位内固定治疗的效果，观察各自方案对患者腕关节功能的影响。方法选取2014年11月～2016年11月因老年不稳定性桡骨远端骨折于我院行手术治疗的80例患者作为研究对象，随机分为对照组和观察组，各40例。对照组采用钢板内固定术，观察组采用外固定支架联合小夹板外固定治疗，比较两组的临床疗效。结果观察组的手术时间短于对照组，术中出血量少于对照组，差异有统计学意义（P＜0.05）。两组的骨折愈合时间比较，差异无统计学意义（P＞0.05）。两组治疗后3、6个月的掌倾角、尺偏角优于治疗前，差异有统计学意义（P＜0.05）。两组治疗后3、6个月的掌倾角、尺偏角比较，差异无统计学意义（P＞0.05）。对照组治疗3个月时的总优良率为97.50%，高于观察组的77.50%，差异有统计学意义（P＜0.05）。观察组治疗6个月后的总优良率为92.50%，与对照组的100.00%比较，差异无统计学意义（P＞0.05）。结论对于不稳定性桡骨远端骨折老年患者而言，外固定支架联合小夹板外固定与切开复位内固定均效果显著，可有效改善患者的腕关节功能，后者早期腕关节功能恢复更好，但前者创伤小，安全性更高，对腕关节功能恢复要求不高的患者可推广应用。

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	曾欢高
	毕殿海
	廖勇
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关键词 ：外固定支架, 切开复位内固定, 老年不稳定性桡骨远端骨折

Abstract：ObjectiveTo investigate the curative effect of combining external fixation and small splint external fixation as well as open reduction and internal fixation in elderly patients with unstable distal radius fractures,and to observe the effect of each program on the wrist function.Methods80 elderly patients who came to our hospital for operative treatment for unstable distal radius fracture from November 2014 to November 2016 were selected and randomly divided into the control group and the observation group,40 cases in each group.The control group was treated with plate internal fixation,the observation group was treated with external fixation combined with small splint external fixation.The clinical effects of the two groups was compared.ResultsThe operation time in the observation group was shorter than that in the control group,and intraoperative blood loss in the observation group was less than that in the control group, with significant difference(P＜0.05).There was no significant difference in the time of fracture healing between the two groups(P＞0.05).The angle of palmar inclination and ulnar deviation of the two groups at 3 and 6 months after treatment were better than those before treatment,with significant difference (P＜0.05).There was no significant difference in the angle of palmar inclination and ulnar deviation of the two groups at 3 and 6 months after treatment(P＞0.05).The total excellent and good rate of the control group after 3 months treatment was 97.50%,which was higher than 77.50%of the observation group,with significant difference (P＜0.05).After treatment for 6 months,the total excellent and good rate of the observation group was 92.50%,compared with 100.00%of the control group,the difference was not statistically significant(P＞0.05).ConclusionFor the elderly patients with unstable distal radius fractures,the effect of combination of external fixation and small splint external fixation as well as open reduction and internal fixation are both significant, which can effectively improve the wrist function of the patients,the early recovery of the wrist function is better for the latter,but the former has smaller trauma and higher security,which is available for promotion among patients with low requirements for the recovery of wrist function.

Key words： External fixation Open reduction and internal fixation Elderly unstable distal radius fracture

作者简介: 曾欢高（1984-），男，硕士，主治医师，研究方向：颈椎病、腰椎间盘突出症、肩袖损伤、骨性关节炎等

引用本文:

曾欢高；毕殿海；廖勇；廖水生. 外固定支架与切开复位内固定术对老年不稳定性桡骨远端骨折的疗效及对腕关节功能的影响[J]. 中国当代医药, 2017, 24(31): 92-94转97.
ZENG Huan-gao ；BI Dian-hai；LIAO Yong； LIAO Shui-sheng. Influence of external fixation and open reduction and internal fixation on the curative effect of unstable distal radius fracture and the wrist function in elderly patients. 中国当代医药, 2017, 24(31): 92-94转97.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2017/V24/I31/92

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