摘要
目的比较掌侧锁定钢板与外固定架治疗桡骨远端C型骨折的疗效。方法采用随机对照法,纳入2014年10月到2017年10月收治的桡骨远端C型骨折患者,随机分为两组,分别采用外固定架或者掌侧锁定钢板治疗。比较两组患者手术时间、术中出血量、骨折愈合时间、术后并发症发生率;比较末次随访时患者腕关节活动度、桡骨掌倾角、尺偏角;比较健、患侧握力比值和患侧腕关节Gartland-Werley评分。结果共纳入30例患者,其中外固定架组14例,掌侧锁定钢板组16例。两组患者术后均随访1年。结果显示,掌侧锁定钢板组手术时间长于外固定架组,术中出血量多于外固定架组,但末次随访时桡骨掌倾角、尺偏角恢复水平优于外固定架组(P<0.05);两组骨折愈合时间,末次随访时腕关节屈伸、旋转活动度,健、患侧握力比,患侧腕关节Gartland-Werley评分等,均未见明显统计学差异(P>0.05);两组患者均未发生术后并发症。结论对于桡骨远端C型骨折,外固定架治疗的手术风险小于掌侧锁定钢板,但会造成术后一定程度的复位丢失,然而这种复位丢失并不影响患者的腕关节功能恢复。
Objective To compare the efficacy of volar locking plate and external fixator in treating distal radius type C fracture. Methods A randomized controlled study was used. Patients with distal radius type C fractures from October 2014 to October 2017 were included and randomly divided into 2 groups： external fixator group and volar locking plate group,treated with external fixator and volar locking plate respectively. The duration of operation, intra-operative blood loss,fracture healing time and incidence of postoperative complications were compared between the two groups. The wrist joint activity, radial inclination, palmar tilt, the ratio of the grip strength with two hands and the Gartland-Werley score of the wrist joint at the last follow-up were measured and compared. Results A total of 30 patients were included and followed up for 1 year. There were 14 cases in external fixation group and 16 cases in volar locking plate group. The duration of operation in the volar locking plate group was longer than external fixator group and the blood loss was more. At the last follow-up, the palmar tilt and radial inclination of the volar locking plate group were better than external fixator group. The fracture healing time, wrist flexion and extension, wrist rotation, the grip strength ratio with two hands and the Gartland-Werley score of the wrist joint had no significant difference between the two groups. No postoperative complications occurred in the two groups.Conclusion The operative risk of external fixator is less than volar locking plate in treating distal radius type C fracture.External fixator can cause reduction loss after operation at a certain degree. However, the loss of the reduction does not affect the recovery of wrist joint function.
作者
李志阳
张新营
陈永彩
袁正江
LI Zhiyang;ZHANG Xinying;CHEN Yongcai;YUAN Zhengjiang(Department of Microsurgery,First Affiliated Hospital,Henan University of Science and Technology,Luoyang 471000,China.)
出处
《组织工程与重建外科杂志》
2018年第3期148-151,共4页
Journal of Tissue Engineering and Reconstructive Surgery
关键词
桡骨远端C型骨折
掌侧锁定钢板
外固定架
疗效比较
Distal radius type C fracture
Volar locking plate
External fixator
Curative effect comparison
