桡骨远端不稳定型骨折的远期疗效分析

目的探讨桡骨远端不稳定型骨折的最佳治疗方法。方法对2005年7月至2010年7月佛山市中医院收治的分别采用闭合复位夹板外固定、闭合复位支架外固定、切开复位LCP内固定方法治疗的204例桡骨远端不稳定型骨折的临床资料进行回顾性分析。结果所有患者均获随防,平均16个月,按Gartland and Werley标准评分:夹板组优良率为70.6%,支架组及LCP组优良率均为83.8%。其中A型骨折3种治疗方法的优良率无明显差别,B型骨折中LCP内固定的优良率最高,C型骨折中的支架外固定的优良率最高。放射学用Lidstrom分级评价:支架组和LCP组功能复位效果较夹板组好。并发症发生率LCP组明显小于夹板组及支架组。结论桡骨远端不稳定型骨折,治疗方法可根据AO分型的不同进行选择,其中支架外固定及切开复位LCP内固定疗效差别不大,均明显好于夹板外固定,但因夹板外固定价廉及治疗简便,仍可用于部分A型骨折中。

Analysis of long term results of treatment of unstable distal radius fracture

Objective To explore the best therapy for unstable distal radius fractures. Methods retrospective analysis was conducted on 204 cases with unstable distal radius fractures in this hospital from July 2005 to July 2010.They were treated by different methods,including close reduction and splint external fixation,close reduction and stent external fixation,open reduction and LCP internal fixation. Results All the patients were followed up at average of 16 months.According to the Gartland and Werley Standard: the percentage of excellent or good results in splint group was 70.6%,and that in stent and LCP groups were 83.8%.There was no obvious difference of excellent and good results between these three therapies in Type A fractures.But the highest rate of excellent and good results was shown in Type B fractures LCP group.Lastly the best result in Type C fractures was in stent group.Evaluated by Lidstrom system in radiology,effect of the stent and LCP groups were better than that of the splint group.But LCP group had less complication than splint and stent groups. Conclusion Treatment of unstable distal radius fractures can be chosen according to the AO typing.Effects of stent external fixation and LCP internal fixation are similar,and both of them are better in effect than splint external fixation.However,due to the price and convenience of splint external fixation,it is still performed in some Type A fractures.