摘要
目的比较单纯锁定钢板内固定和钢板内固定联合外固定架治疗桡骨远端复杂关节内骨折的临床疗效。方法回顾性分析自2010-01—2013-08行手术治疗的38例桡骨远端复杂关节内骨折。单纯采用锁定钢板内固定23例(单纯组),采用锁定钢板内固定联合外固定架治疗15例(联合组)。比较2组手术相关指标、影像学指标、腕关节功能评分。结果单纯组切口总长度短于联合组,联合组桡骨高度、掌倾角恢复程度优于单纯组,差异有统计学意义(P<0.05);2组手术时间、术后当天VAS评分、尺倾角、关节面台阶差异无统计学意义(P>0.05)。术后1年Mayo腕关节功能评分中,联合组总分、活动度、握力、功能高于单纯组,差异有统计学意义(P<0.05);但2组疼痛评分差异无统计学意义(P>0.05)。单纯组发生关节炎4例,联合组发生关节炎3例,2组关节炎发生率比较差异无统计学意义(χ2=0.041,P>0.05)。结论上述2种方法治疗桡骨远端复杂关节内骨折均能有效复位,恢复关节功能。钢板内固定联合外固定架固定复位效果更好,术后1年腕关节功能更优,但有钉道感染风险。
Objective To explore the clinical outcomes for complicated articular distal radius fractures（DRF） treated with two surgical methods, namely, open reduction internal fixation with volar locking plate （VLP） and the combined utilization of open reduction internal fixation with volar locking plate and external fixator with dispofix（VLP＆D）. Methods Thirty-eight patients with AO-type C DRF from January 2010 to august 2013 were indentified from a retrospective database. Twenty-three of them underwent the fixation with VLP and the others were treated with VLP＆D fixator. All the patients were followed for at least 1 year, and outcomes were assessed and compared in operation-related situations, radiological parameters and the Mayo wrist function score. Results The mean incision length was shorter for VLP than VLP＆D, but there was a greater recover of radial height and volar angle with VLP＆D than VLP （P 〈0.05）. No significant difference was found in operation duration,radial inclination, articular step or VAS between the 2 groups （P 〉0.05）. All the patients of the 2 groups were estimated with Mayo system one year after the operation, and VLP＆D showed better score in function, range of motion and grip strength than VLP （P 〈0.05）, but no significant difference were found in pain score between the 2 groups（P 〉0.05）. At the time point of 1 year, 4 cases of carpitis were found in VLP and 3 were found in VLP＆D, and no significant difference was found in the incidence rate of carpitis between the 2 groups （X2=0.041,P 〉0.05）. Conclusion VLP and VLP＆D are both effective in reconstruction and recovering wrist function for complicated articular DRF. VLP＆D shows better outcomes in terms of radiological parameters and Mayo score, but run the risk of pin track infection outside the hospital.
出处
《中国骨与关节损伤杂志》
2016年第3期277-280,共4页
Chinese Journal of Bone and Joint Injury
关键词
桡骨远端复杂关节内骨折
锁定钢板
外固定架
Complicated articular distal radius fractures
Volar locking plate
External fixator
