摘要
目的探讨采用腕关节镜技术联合尺骨短缩术治疗桡骨远端骨折后畸形愈合的临床效果。方法 2013年9月至2015年9月我院收治桡骨远端骨折后畸形愈合病人67例,根据手术方法分为三组:联合治疗组,35例,采用腕关节镜技术联合尺骨短缩术治疗;尺骨短缩组,21例,采用单一的尺骨短缩术进行治疗;腕关节镜组,11例,采用单一的腕关节镜技术清理关节腔治疗。比较各组治疗后的数字评价量表(numerical rating scale,NRS)疼痛评分和上肢、肩、手功能障碍(disabilities of the arm,shoulder and hand,DASH)腕关节评分。结果联合治疗组、尺骨短缩组治疗后的NRS疼痛评分分别为(1.32±0.52)分、(1.63±0.71)分,两组的腕关节DASH评分分别为(15.42±6.31)分、(18.03±7.64)分,均较术前明显改善,差异有统计学意义(P均<0.05);但腕关节镜组治疗后改善不明显。联合治疗组治疗后的NRS疼痛评分最低,腕关节镜组最高,三组间得分进行两两比较,差异均有统计学意义(均P<0.05)。联合治疗组、尺骨短缩组治疗后的腕关节DASH评分差异并无统计学意义,但均优于腕关节镜组,差异均有统计学意义(均P<0.05)。结论尺骨短缩术联合腕关节镜技术对于桡骨远端骨折后畸形愈合造成的疼痛及功能障碍的改善具有积极的临床意义。
Objection To evaluate the clinical efficacy of distal radius fracture malunion with ulnar shortening and wrist arthroscopy.Methods From September2013to September2015,67distal radius fracture malunion patients in our hospital were enrolled in this retrospective study and were divided into three groups in terms of the surgical procedures:the combined therapy group(n=35)treated with ulnar shortening combined with wrist arthroscopy,ulnar shortening group(n=21)given ulnar shortening,and wrist arthroscopy group(n=11)subjected to wrist arthroscopy.The numerical rating scale(NRS)pain scores,disabilities of the arm,shoulder and head(DASH)scores were compared.Results The NRS pain scores post-treatment in combined therapy group and ulnar shortening group were1.32±0.52and1.63±0.71respectively,and the DASH scores were15.42±6.31and18.03±7.64respectively,which were significantly improved as compared with those preoperation(P<0.05for all).There was no significant improvement in the wrist arthroscopy group before and after operation.The NRS pain scores in the combined therapy group were the lowest,and highest in the wrist arthroscopy group.There were obvious differences among three groups and between every two groups(P<0.05for all).The differences in DASH scores between the combined therapy group and the ulnar shortening group were not statistically significant,but higher than in the arthroscopy group(P<0.05for all).Conclusion Ulnar shortening combined with wrist arthroscopy for the pain and dysfunction after distal radius fracture malunion has a positive clinical significance.
作者
胡岚翔
余化龙
何霞
刘亚东
严玉勇
HU Lanxiang;YU Hualong;HE Xia;LIU Yadong;YAN Yuyong(Department of Hand and Foot Surgery, Dongfeng Hospital Affiliated to Hubei University of Medicine, Shiyan 442000, China)
出处
《骨科》
CAS
2017年第5期354-359,共6页
ORTHOPAEDICS
关键词
桡骨远端骨折
畸形愈合
腕关节镜
尺骨
截骨术
治疗结果
Distal radius fracture
Malunion
Wrist arthroscopy
Ulna
Osteotomy
Treatment outcome
