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两种内固定方法治疗桡骨远端骨折的疗效比较研究 被引量:42

Comparison of the therapeutic effects of two kinds of internal fixation for distal radial fractures
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摘要 目的对比斜T型锁定加压接骨板系统(locking compression plate,LCP)及AO普通T型板钉系统治疗桡骨远端骨折的疗效。方法对1999年3月至2009年12月我科收治的313例桡骨远端骨折患者中获得完整随访资料的72例(73侧),采用Sarmiento改良的Gartland—Werley评分系统(CW评分)进行术后功能评分,并比较LCP(I^P组)及AO普通T型板钉系统(普通组)内固定术后两组腕关节的功能。结果术后随访时间为3个月至6年,平均25.4个月。X线片显示骨折全部愈合。GW评分LCP组平均1.98分,普通组平均1.43分,两组差异无统计学意义(P〉0.05);两组在患者满意度上差异也无统计学意义(P〉0.05)。结论对于绝大部分复位失败的桡骨远端A型骨折、移位明显的B型骨折及C型骨折,应用AO普通T型板钉固定就可满足手术需要,而对于骨质疏松严重的粉碎性C型骨折,LCP的内固定效果更为可靠。 Objective To compare therapeutic effects of oblique T-locking compression plate system (LEP) and general AO T-plate and screw system-for treatment of distal radius fractures. Metbods From March 1999 to December 2009, 313 cases of distal radial fractures were treated with LCP or AO T-plate and screw system in our department, were follow-up. Postoperative functional score were performed by Sarmiento modified Gartland-Werley scoring system (GW score) was used to assess the postoperative functions in 72 (73 wrists) cases with complete follow-up. Wrist joint function was compared between patients who underwent LCP fixation (LCP group) and patients who underwent AO T-plate and screw system fixation (routine group). Results The follow-up time was 3 months to 6 years, with an average of 25.4 months. Bone union was seen in X-rays of all cases. The average score of the LCP group was 1.98 points, and the AO T-plate and screw system group was 1.43 points. There was no significant difference between the two groups ( P 〉 0.05), and the differences of patient satisfaction between the two group were not notable either ( P 〉 0.05). Conclusion AO T- plate and screw system is suitable for majority of type A fractures with failed manipulative reduction, type B fractures with obvious displacement, and type C fractures. LCP fixation is more reliable for type C comminuted fractures with osteoporosis.
出处 《中华手外科杂志》 CSCD 北大核心 2010年第6期340-343,共4页 Chinese Journal of Hand Surgery
基金 基金项目:国家自然科学基金(30973066),十一五科技支撑计划(2007BA104800),首都医学发展科研基金资助项目(2007-2011)
关键词 桡骨骨折 骨折固定术 病例对照研究 板钉固定 LCP Radius fractures Fracture fixation, internal Case-control studies Plate and screw fixation Locking compression plate
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