摘要
目的比较手术与保守两种方法治疗桡骨远端不稳定型骨折的临床疗效。方法于2013年12月至2015年1月收集石河子大学第一附属医院骨科收治的桡骨远端骨折患者68例,随机分为手术组32例和保守组36例。手术组予以采用切开复位T形钢板内固定治疗,保守组采用骨折闭合复位,改进的石膏外固定治疗。随访患者定期行X线观察两组固定方式腕关节的掌倾角、尺偏角及桡骨高度情况,用Gartland-Werley腕关节功能评分及PRWE评分系统来评估两组固定方式治疗桡骨远端骨折的临床疗效。结果 68例患者均获得随访,随访时间3-12个月,平均6.6个月,X线显示所有骨折均达到临床愈合标准。手术组X线中掌倾角、尺偏角及桡骨短缩程度上有差异有统计学意义（t分别为5.67、4.78、14.19,P均〈0.01）;但两组Gartland-Werley腕关节功能优良率（χ^2=3.364;P〉0.05）和PRWE评分（χ^2=0.752;P〉0.05）差异无统计学意义。结论手术治疗桡骨远端不稳定骨折在客观疗效上明显优于保守治疗,桡骨远端不稳定骨折的治疗方式选择应根据年龄、体质及患者对功能等要求决定。
Objective To evaluate the clinical effects after treatment unstable distal radius fracture with surgical and conservative treatment. Methods 68 cases of distal radius fractures were collected from the First Affiliated Hospital of Shihezi University from December 2013 to January 2015,and randomly divided into surgery group（ 32 cases） and conservative group（ 36 cases）. The palmar angle,the ulnar deviation and the radial shortening case were observed using Xray. The Gartland-Werley wrist score and the PRWE scoring system were used to assess the clinical treatment efficacy of distal radius fractures. Results All the 68 patients were followed up for 3-12 months,an average of 6. 6 months,and the X-ray showed all the fractures were clinical healing up to standard. X-ray showed that there was statistically significant in the difference among palmar angle,ulnar deviation and radial shortening（ respectively t = 5. 67,4. 78,14. 19,P〈0.01）. But the differences of the good rate of Gartland-Werley wrist function（ χ^2= 3. 364; P〉0. 05） and PRWE score（ χ^2= 0. 752; P〉0. 05） were not statistically significant. Conclusion Surgical treatment of the unstable distal radius fractures is superior to conservative treatment in the clinical effects,but patients＇ subjective feeling of the effects is insignificant in both methods. The treatment of unstable distal radius fracture should be chosen on the basis of age,physical condition and patients＇ function request.
出处
《济宁医学院学报》
2016年第2期97-100,共4页
Journal of Jining Medical University
关键词
不稳定型
桡骨远端骨折
手术治疗
保守治疗
Unstable
Distal radial fractures
Surgical treatment
Conservative treatment
