Colles骨折Frykman分型：各分型不同体位固定疗效比较

目的：探讨Colles骨折Frykman分型各分型进行不同体位固定治疗的效果。方法：根据Frykman分型方法,选择180例Colles骨折患者,其中Ⅰ型33例,Ⅱ型33例,Ⅲ型24例,Ⅳ型21例,Ⅴ型21例,Ⅵ型21例,Ⅶ型15例,Ⅷ型12例,按研究要求每型分为3组治疗：掌屈尺偏位组（A组）、中立位组（B组）、轻度背伸位组（C组）。随访6～18个月,根据Gartland and Werley功能评估标准对腕关节功能进行评定。结果：（1）Ⅰ、Ⅱ、Ⅲ、Ⅳ型3组间疗效比较,差异无统计学意义（P〉0.05）;（2）Ⅴ、Ⅵ型3组间疗效比较,差异有统计学意义（P〈0.05）;（3）Ⅶ、Ⅷ型3组间疗效比较,差异无统计学意义（P〉0.05）。结论：（1）Ⅰ、Ⅱ、Ⅲ、Ⅳ型Colles骨折采用掌屈尺偏位或中立位或轻度背伸位固定疗效无明显差别,临床治疗时均可采用;Ⅲ、Ⅳ型建议采用中立位或轻度背伸位固定;（2）Ⅴ、Ⅵ型采用中立位或轻度背伸固定疗效较好;（3）Ⅶ、Ⅷ非手术治疗效果较差,建议手术治疗。

Comparison of Various External Fixation for the Treatment of Colles Fracture

Objective：To evaluate the clinical effect of different kinds of external fixation for the treatment of Colles fracture according to the Frykman classification system.Methods：All 180 cases of Colles fracture were followed up,and 33 cases were classified as type Ⅰ,33 cases were type Ⅱ,24 cases were type Ⅲ,21 cases were type Ⅳ,21 cases were type Ⅴ,21 cases were type Ⅵ,15 cases were type Ⅶ,and 12 cases were type Ⅷ,according to the Frykman classification system.Each type of the fractures were divided into three groups for external fixation,the wrist in Cotton-Lorder position group（group A）,the neutral position group（group B）,and the mild dorsiflexion position group（group C）.All patients were following up for 6～18 months.The wrist function was evaluated based on Gartland and Werley scoring system.Results：（1） Compared the wrist function after various fixation in type Ⅰ,Ⅱ,Ⅲ,and Ⅳ,there was no significant difference in the three groups（P0.05）.（2） But in type Ⅴ and Ⅵ,there was significant difference in the three groups（P0.05）.（3） In type Ⅶ and Ⅷ,there was no significant difference in the three groups（P0.05）.Conclusion：（1）The curative effect of the Colles fracture by fixation in Cotton-Lorder position,neutral position,or mild dorsiflexion position were not difference in typeⅠ,Ⅱ,Ⅲ,and Ⅳ.So they all can be used for clinical treatment.But it is recommend to fixate in neutral or mild dorsiflexion position for treating of type Ⅲ and Ⅳ.（2）The curative effect by fixation in neutral position or mild dorsiflexion position was better than in Cotton-Lorder position in type Ⅲ and Ⅳ.（3） The curative effect was poor in type Ⅶ and Ⅷ,so we recommend surgery.