摘要
[目的]比较组合式外固定架与掌侧锁定钢板内固定治疗老年骨质疏松性桡骨远端骨折的临床疗效。[方法]回顾性分析2013年1月~2018年1月诊治的68例老年骨质疏松性桡骨远端骨折,其中采用闭合手法复位组合式外固定架治疗38例(外固定组),采用切开复位锁定钢板内固定治疗30例(内固定组)。比较两组围手术期、随访与影像资料。[结果]68例患者均顺利完成手术。外固定组在手术时间、术中失血量、切口总长度和住院时间方面均显著优于内固定组,差异有统计学意义(P<0.05);但外固定组术中透视次数显著多于内固定组,差异有统计学意义(P<0.05)。68例均获得随访,随访时间(14.37±1.85)个月。末次随访时两组患者ROM和Gartland-Werley评分的差异均无统计学意义(P>0.05)。影像方面:两组患者随术后时间推移,掌倾角、尺偏角均有轻度丢失,但不同时间点间差异无统计学意义(P>0.05);外固定组桡骨茎突高度的丢失不同时间点的差异无统计学意义(P>0.05),而内固定组桡骨茎突高度的丢失差异有统计学意义(P<0.05)。术后3、6和12个月时,外固定组的桡骨茎突高度均显著大于内固定组,差异有统计学意义(P<0.05)。[结论]组合式外固定架治疗老年骨质疏松性桡骨远端骨折操作简单、固定可靠,可同时兼顾对功能与解剖角度的恢复,尤其对于桡骨高度的恢复具有明显临床优势。
[Objective]To compare the clinical outcomes of external fixation versus internal fixation for osteoporotic distal radius fractures in the elderly.[Methods]A retrospective study was done on 68 elderly patients who underwent surgical treat ment for osteoporotic distal radius fractures from January 2013 to January 2018.Among them,38 patients were treated with closed reduction combined external fixator(the EF group),whereas 30 patients received open reduction and internal fixation with volar locking plate(the IF group).The perioperative,follow-up and radiographic documentations were compared between the two groups.[Results]All the 68 patients had operation performed smoothly.The EF group proved significantly superior to the IF group regarding to operation time,intraoperative blood loss,total incision length,and hospital stay(P<0.05),although the EF group had significantly more frequency of fluoroscopy than the IF group during operation(P<0.05).All the patients were followed up for(14.37±1.85)months on average.At the latest follow up,there were no significant differences in various plane range of motions and Gartland-Werley score between the two groups(P>0.05).In term of radiographic assessment,the palmar inclination and ulnar slant got slightly lost over time after operation in both groups,which were not statistically significant(P>0.05).The height of radial styloid in the EF group remained unchanged postoperatively(P>0.05),whereas decreased in the IF group over time.At 3,6 and 12 months postoperatively,the EF group had significantly greater height of radial styloid than the IF group(P<0.05).[Conclusion]The external fixation for osteoporotic distal radius fractures in the elderly is simple and reli able treatment,and can simultaneously restore the functional and anatomical alignments,especially recover the height of radial styloid process.
作者
吴晓林
钟伟
梁答
马振
WU Xiao-lin;ZHONG Wei;LIANG Da;MA Zhen(Department of Joint Surgery,The Affiliated Hospital,Weifang Medical University,Weifang 261031,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2020年第6期512-516,共5页
Orthopedic Journal of China
关键词
骨质疏松性桡骨远端骨折
老年人
外固定
内固定
osteoporotic distal radius fractures
exter nal fixation
internal fixation
elderly
