摘要
目的分析手法复位石膏固定和克氏针结合外固定架治疗老年桡骨远端关节内骨折的疗效。方法选取2007年12月至2009年12月我院收治60岁以上的老年桡骨远端关节内骨折患者135例,手法复位石膏外固定80例,克氏针内固定结合外固定架固定55例,对上述两种治疗方法的疗效进行比较。结果所有患者均获得随访,随访时间6~18个月,平均10.5个月。采用Gartland and Werley腕关节功能评分评价疗效,手法复位石膏外固定组优良率72.5%,克氏针结合外固定架固定组优良率89.1%,克氏针结合外固定架固定组疗效优于石膏外固定组,差异具有统计学意义(P<0.05)。PRWE评分两组差异不具有统计学意义(P>0.05)。两组在患者满意度上差异也不具有统计学意义(P>0.05)。结论老年桡骨远端关节内骨折,克氏针结合外固定架固定组疗效优于石膏外固定组。因为老年患者对上肢功能的要求减低,治疗的目标在于恢复患肢的功能达到可以接受的程度即可,如果患者对腕关节功能要求不高,保守治疗是一种适当的治疗措施。
Objective To compare the outcomes of operation and manual reduction and plaster immobilization in management of senile intra-articular distal radial fractures.Methods Retrospective analysis of the outcomes of the 135 senile paients with intra-articular distal radial fracture who were treated from December 2007 to December 2009 in our department.80 cases were treated with manual reduction and plaster immobilization,and 55 cases with external fixator and limited internal fixation.Results 135 cases were all followed-up,mean follow-up period was 10.5 months(6~18 months).According to Gartland and Werley wrist evaluation score,the excellent rate was 89.1% for external fixator combined with limited internal fixation and 72.5% for manual reduction and plaster immobilization.The difference was statistically significant(P0.05).But there was not significant difference in Patient-Rated Wrist Evaluation(PRWE) and the satisfaction of the patients for the two groups(P0.05).Conclusion In treatment of senile intraarticular distal radius fracture,external fixator combined with limited internal fixation can produce more satisfactory effects than plaster immobilization.However,to regain the function to an acceptable level is the main target of treating senile intra-articular distal radius fractures.The large majority of senile intra-articular distal radius fracture can be treated with nonoperative measures in the form of manual reduction and plaster immobilization,particularly in older patients with limited functional demands.
出处
《实用骨科杂志》
2011年第4期321-324,共4页
Journal of Practical Orthopaedics
关键词
老年
桡骨远端
骨折
石膏外固定
外固定架
senile
distal radius
fracture
plaster fixation
external fixator