摘要
背景:老年患者骨质疏松性桡骨远端骨折常使用外固定支架治疗,MIIG X3(minimally invasive injectable graft)可强化骨松质、填充骨缺损,藉此增加外固定的稳定性。目的:探讨微创技术下,应用外固定结合MIIG在老年桡骨远端骨折中的临床效果。方法:将符合病例纳入标准的患者随机分为两组:A组(25例)和B组(31例)。在微创技术下,A组使用外固定治疗;B组在使用外固定治疗的同时,采用MIIG进行注射强化。术后定期随访,观察是否有并发症(骨折移位、钉松动、钉道感染)、复位丢失,以及影像学骨折愈合等情况。根据Dienst腕关节评分标准,术后对患侧腕关节进行疗效评价。结果:所有患者均获得随访,骨折均愈合。B组并发症(2例)明显少于A组(7例),差异有统计学意义(P<0.05)。B组复位丢失长度明显低于A组[(1.81±0.82)mm vs(2.95±1.20)mm,P<0.01]。腕关节Dienst功能评价:A组,优良率76.0%;B组,优良率83.9%,两者比较无显著统计学差异(P>0.05)。结论:微创技术下外固定结合MIIG治疗老年桡骨远端骨折疗效满意,具有创伤小、固定可靠、并发症少、关节功能恢复好等优点。
Background：External fixator is often used for osteoporotic distal radius fractures in elderly patients. MIIG X3 （minimally invasive injectable graft） can enhance the cancellous bone and fill bone defects, thereby increasing the stability of external fixation. Objective：To investigate the clinical outcome of external fixation and MIIG for distal radius fractures in elderly patients. Methods：The cases complying with inclusion criteria were randomly divided into two groups：group A （n=25） and group B （n=31）. The patients in the group A were treated with external fixation, while the patients in the group B underwent external fixation and MIIG X3 injection. Postoperative follow-up were obtained regularly to observe whether there would be compli-cations, restoration loss, or infection. The fracture healing and wrist joint function were evaluated by X ray examination and Dienst score, respectively. Results：All these patients were followed up and fractures healed. The incidence of complications in group B was signifi-cantly lower than that of group A （2 cases versus 7 cases, P〈0.05）. The restoration loss of group B was significantly less than that of group A （[1.81 ± 0.82] mm versus [2.95 ± 1.20] mm, P〈0.01）. According to Dienst system, the excellent-and-good achievement rate was 76.0%in group A and 83.9%in group B （P〉0.05）. Conclusions：Minor wound, stable fixation, fewer complications, and better joint function can be achieved after minimally invasive treatment by external fixation and MIIG X3 injection in elderly patients with distal radius fracture.
出处
《中国骨与关节外科》
2014年第2期138-141,共4页
Chinese Journal of Bone and Joint Surgery
关键词
微创
桡骨远端骨折
外固定
骨质疏松
微创可注射型硫酸钙人工骨
Minimally invasive surgical treatment
Distal radius fracture
External fixation
Osteoporosis
Minimally invasive injectable graft
