摘要
目的比较经掌侧入路锁定加压钢板固定术与手法复位治疗老年桡骨远端骨折的效果。方法66例老年桡骨远端骨折患者,依据随机对照原则分为观察组和对照组,每组33例。观察组开展经掌侧入路锁定加压钢板固定术治疗,对照组开展手法复位治疗。比较两组患者治疗效果,骨折愈合时间,治疗前与治疗6个月后骨折恢复情况、腕关节功能Cooney评分。结果观察组治疗优良率93.94%高于对照组的75.76%,差异有统计学意义(P<0.05)。观察组骨折愈合时间(11.47±2.02)周短于对照组的(14.28±3.11)周,差异有统计学意义(P<0.05)。治疗前,两组患者桡骨缩短、尺偏角、掌倾角比较,差异无统计学意义(P>0.05);治疗6个月后,两组患者桡骨缩短、尺偏角、掌倾角均优于本组治疗前,且观察组桡骨缩短(0.31±0.10)mm小于对照组的(2.89±0.81)mm,尺偏角(20.19±4.13)°、掌倾角(7.15±1.82)°均大于对照组的(10.44±3.02)、(1.87±0.38)°,差异有统计学意义(P<0.05)。治疗前,两组患者疼痛、功能状态、活动度、患侧背伸/掌屈活动度、握力评分比较,差异无统计学意义(P>0.05)。治疗6个月后,两组患者疼痛、功能状态、活动度、患侧背伸/掌屈活动度、握力评分均较治疗前升高,且观察组疼痛、功能状态、活动度、患侧背伸/掌屈活动度、握力评分分别为(19.81±3.47)、(18.35±3.61)、(21.52±3.81)、(19.10±4.14)、(16.53±3.22)分,均高于对照组的(16.20±3.03)、(16.11±3.47)、(18.45±3.15)、(16.49±3.81)、(14.72±3.06)分,差异有统计学意义(P<0.05)。结论经掌侧入路锁定加压钢板固定术治疗老年桡骨远端骨折效果优于手法复位,患者腕功能恢复效果更佳,值得临床推荐。
Objective To compare the effect of volar locking compression plate fixation and manual reduction in the treatment of distal radius fractures in the elderly.Methods A total of 66 elderly patients with distal radius fracture were divided into observation group and control group according to randomized control principle,with 33 cases in each group.The observation group underwent volar locking compression plate fixation,and the control group underwent manual reduction treatment.The therapeutic effect,fracture healing time,fracture recovery before treatment and 6 months after treatment,and Cooney score of wrist joint function were compared between the two groups.Results The excellent-effective rate of treatment in the observation group was 93.94%,which was higher than that of 75.76%in the control group,and the difference was statistically significant(P<0.05).The fracture healing time in the observation group was(11.47±2.02)weeks,which was shorter than that of(14.28±3.11)weeks in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in radius shortening,ulnar inclination and radial inclination between the two groups(P>0.05).After 6 months of treatment,the radius shortening,ulnar declination and radial inclination in both groups were better than those before treatment in this group;the radius shortening of(0.31±0.10)mm in the observation group was shorter than that of(2.89±0.81)mm in the control group;the ulnar declination of(20.19±4.13)°and radial inclination of(7.15±1.82)°in the observation group were greater than those of(10.44±3.02)and(1.87±0.38)°in the control group;the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in scores of pain,functional status,range of motion,range of motion in dorsalis/palm flexion and grip strength between the two groups(P>0.05).After 6 months of treatment,the scores of pain,functional status,range of motion,range of motion in dorsalis/palm flexion and grip strength increased in both groups;in the observation group,the scores of pain,functional status,range of motion,range of motion in dorsalis/palm flexion and grip strength were(19.81±3.47),(18.35±3.61),(21.52±3.81),(19.10±4.14)and(16.53±3.22)points,which were higher than those of(16.20±3.03),(16.11±3.47),(18.45±3.15),(16.49±3.81)and(14.72±3.06)points in the control group;the differences were statistically significant(P<0.05).Conclusion Volar locking compression plate fixation is more effective than manual reduction in the treatment of distal radius fractures in the elderly,and the patients have better restoration of wrist function,which is worthy of clinical recommendation.
作者
穆怀磊
佟亮
MU Huai-lei;TONG Liang(Department of Orthopaedics,Yuhong Hospital of Traditional Chinese Medicine,Shenyang 110029,China)
出处
《中国现代药物应用》
2023年第15期58-61,共4页
Chinese Journal of Modern Drug Application
