摘要
目的探讨掌背侧联合入路植骨钢板内固定与外固定支架固定治疗AO C型老年性桡骨远端骨折的临床疗效分析。方法回顾性收集85例于2015年1月至2020年1月期间在佛山复星禅诚医院就诊的AO C型桡骨远端老年性骨质疏松性骨折患者,分为掌背侧联合入路切开复位钢板内固定组(ORIF)和闭合复位外固定架固定组(CREF),随访并比较两组患者手术时间、骨折愈合时间、住院天数、术后并发症、术后影像学情况、腕关节活动度、腕关节功能Garland-Werley评分。结果所有患者均获得随访,平均(15±4)个月。CREF组手术时间[(41±10)min]、骨折愈合时间[(9.2±2.7)w]、住院天数[(4.1±1.0)d]优于ORIF组[(72±9)min、(12.0±2.5)w、(7.4±1.2)d],(P<0.05)。两组患者术后影像学比较中,ORIF组关节面塌陷程度[(0.7±1.3)mm]、掌倾角[(10.5±1.6)°]方面复位情况程度优于CREF组[(1.2±1.3)mm、(8.0±1.5)°](P<0.05)。术后1年患者活动度功能均恢复良好,ORIF组的屈曲、背伸功能程度优于CREF组(P<0.05)。两组并发症发生率及术后1年Garland-Werley功能评分均无差异无统计学意(P>0.05)。结论掌背侧联合入路植骨钢板内固定与外固定架固定治疗AO C型老年性桡骨远端骨折均有良好的效果,但在患者术后腕关节活动度方面,掌背侧联合入路植骨钢板内固定更有优势。
Objective To investigate the clinical effect of combined volar dorsal approach bone graft plate internal fixation and external fixation in the treatment of of elderly type C distal radius fractures.Methods 85 patients with AO C type distal radius osteoporotic fractures in our hospital from January 2015 to January 2020 were selected as the research objects.According to the different treatment methods,all the subjects were divided into two groups:open reduction and plate internal fixation group(ORIF)and closed re-duction and external fixation group(CREF).The operation time,fracture healing time,hospital stay,postop-erative complications,postoperative imaging,wrist range of motion and garland and werley score of wrist function were observed and compared between the two groups.Results All patients were followed up for an average of(15±4)months.The operation time of CREF group was(41±10)min,fracture healing time(9.2±2.7)w,hospitalization days(4.1±1.0)d was better than ORIF Group[(72±9)min,(12.0±2.5)w,(7.4±1.2)d],(P<0.05).In the comparison of postoperative imaging between two groups,the collapse degree of joint surface in ORIF group was(0.7±1.3)mm,palm inclination(10.5±1.6)°.The degree of reduction was better than that of CREF Group[(1.2±1.3mm),(8.0±1.5)°](P<0.05).The mobility of patients recovered well in one year af-ter operation,and the flexion and back extension of ORIF group were better than those in CREF group(P<0.05).There were no significant difference in the incidence of complications between the two groups and gar-land werley function score in 1 year after operation(P>0.05).Conclusion The combined volar dorsal ap-proach with bone graft plate internal fixation and external fixation have good results in the treatment of AO C type elderly distal radius fractures,but in the aspect of postoperative wrist movement,the combined volar dor-sal approach with bone graft plate internal fixation has more advantages。
作者
林炳基
郭培义
张子宏
柯森淼
汪洋
Lin Bingji;Guo Peiyi;Zhang Zihong;Ke Sen-miao;Wang Yang(Department of Orthopedics,Central Hospital of Chancheng District,FoShan 528000,China;Department of Orthopedics,Chi Feng Cancer Hospital,Chi Feng 024000,China)
出处
《中华老年骨科与康复电子杂志》
2021年第5期284-290,共7页
Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)
基金
2019佛山市科技局(1920001000934)。
关键词
桡骨骨折
老年人
外固定
骨折内固定
Radius fractures
Aged
External fixation
Fracture fixation,internal
