摘要
目的探讨微创内固定支架经皮微创内固定治疗C型老年桡骨远端骨折的临床效果。方法回顾性分析2015年3月—2018年3月厦门大学附属成功医院收治C型老年桡骨远端骨折患者97例,男性62例,女性35例;年龄60~78岁,平均67.4岁。按固定方式不同分为外固定支架组(48例)和微创组(49例),外固定支架组行外固定支架固定治疗,微创组行微创内固定支架经皮微创内固定治疗。比较两组患者手术效果、影像学指标、骨折端骨痂生长愈合情况及术后并发症情况。结果术后6个月,微创组优良率(93.88%)高于外固定支架组(79.17%)(P<0.05),桡骨高度(12.42±4.60)mm高于外固定支架组(8.53±5.59)mm,尺偏角(22.50±5.96)°、掌倾角(11.06±5.82)°大于外固定支架组尺偏角(18.93±5.20)°、掌倾角(8.45±4.78)°(P<0.05);微创组术后1、2个月骨折端骨痂生长愈合情况Lane-Sandhu X线片评分分别为(1.67±0.29)分、(3.78±0.66)分,优于外固定支架组(1.15±0.37)分、(2.82±0.54)分(P<0.05);微创组术后并发症发生率(6.12%)低于外固定支架组(20.83%)(P<0.05)。结论微创内固定支架经皮微创内固定治疗C型老年桡骨远端骨折患者手术效果好,有利于骨折端骨痂生长愈合,术后并发症较少,临床治疗可参考。
Objective To investigate the clinical effect of percutaneous minimally invasive internal fixation with minimally invasive internal fixator in the treatment of type C distal radius fractures in the elderly.Methods From Mar.2015 to Mar.2018,97 elderly patients with type C distal radius fractures were selected.There were 62 males and 35 females,and their age was 60-78(67.4 on average)years.The patients were randomly divided into control group(n=48,fixed with external fixator)and study group(n=49,fixed with percutaneous minimally invasive internal fixation with minimally invasive internal fixator)by number table method.The operative effect,imaging parameters,callus growth and healing at fracture end and complications were compared between the two groups.Results The excellent and good rate was 93.88%in the study group at 6 months after operation,which was higher than 79.17%of the control group(P<0.05).At six months after operation,the radius height(12.42±4.60)mm of the study group was higher than(8.53±5.59)mm of the control group,and the ulnar angle(22.50±5.96)°and palmar angle(11.06±5.82)°of the study group were higher than ulnar angle(18.93±5.20)°and palmar angle(8.45±4.78)°of the control group(P<0.05).The Lane-Sandhu X-ray scores of callus growth and healing at fracture end of the study group were(1.67±0.29)and(3.78±0.66),respectively,which were better than those of the control group(1.15±0.37)and(2.82±0.54)at 1 month and 2 months after operation(P<0.05).The incidence of postoperative complications was 6.12%in the study group,which was lower than 20.83%of the control group(P<0.05).Conclusion Percutaneous minimally invasive internal fixation with minimally invasive internal fixator is effective for the treatment of type C distal radius fracture in elderly patients,and is conducive to callus growth and healing at the fracture end,with fewer complications after operation.It can be used as a reference for clinical treatment.
作者
简国坚
陈飞雄
谢德胜
刘好源
JIAN Guo-jian;CHEN Fei-xiong;XIE De-sheng;LIU Hao-yuan(Department of Orthopedics,Successful Hospital Affiliated to Xiamen University,Xiamen 361000,Fujian)
出处
《创伤外科杂志》
2020年第4期275-279,共5页
Journal of Traumatic Surgery
基金
福建省自然科学基金(2016J01091)。
关键词
桡骨远端骨折
微创内固定
外固定支架
老年
distal radius fractures
minimally invasive internal fixation
external fixator
elderly
