手法复位后小夹板与石膏托联合固定治疗老年桡骨远端骨折

目的：评价手法复位后小夹板与石膏托联合固定治疗老年桡骨远端骨折的效果。方法：2009年1月至2011年1月，采用手法复位后小夹板与石膏托联合固定的方法治疗老年桡骨远端骨折122例，男43例，女79例；年龄60-86岁，平均74岁；交通事故伤13例，滑倒摔伤109例；伤后到就诊时间30min～7d。均为闭合性骨折。随访内容包括：x线表现，腕关节的疼痛程度、功能状况、活动范围、握力。采用Cooney等修订的Green-0’Brien腕关节评分标准进行评价。结果：随访时间3个月-2年，平均15．4个月。8例骨折再次移位（桡侧移位4例，背侧移位3例，掌侧移位l例），再次复位4例，转为手术治疗2例，拒绝再次复位或手术2例。中后期发现桡骨短缩13例。所有患者骨性愈合。按上述标准评定，优46例，良65例，中6例，差5例。结论：采用手法复位后小夹板与石膏托联合固定治疗老年桡骨远端骨折的方法．能较好地克服桡骨远端骨折的再次移位．恢复腕关节功能．是治疗老年桡骨远端骨折的有效方法．

The combined fixation with splints and plaster after closed reduction for the treatment of distal fractures of radius in elderly patients

Objective: To evaluate the effects of combined fixation with splints and plaster after closed reduction for the treatment of distal fractures of radius in elderly patients Methods: From January 2009 to January 2011, 122 patients with distal fractures of radius were treated by the united fixation with splints and plaster after closed reduction. There were 43 males and 79 females, ranging in age from 60 to 86 years with an average of 74 years. Among the patients, traffic accident injury was in 12 cases and fall injury was in 109 cases;all fractures were closed, the time form injury to visit was for 30 min to 7 days. The X-rays, wrist pain, functional status, range of motion and grasp force of patients were observed at follow-up. Cooney modified Green-O'Brien standard was used to evaluate the clinical effects. Results: All the patients were followed up from 3 months to 2 years with an average of 15. 4 months. Re-displacement occurred in 8 cases (including 4 cases radial displacement, 3 cases dorsal displacement, 1 case palmaris displacement) and re-reduction occurred in 4 cases, surgical treatment was in 2 cases, refused to reset or surgical treatment in 2 cases. Radial shorten in 13 cases middle-later period. All fractures obtained healed. According to the Green-O'Brien standard, 46 cases got excellent results, 65 good, 6 fair, and 5 poor. Conclusion: The combined fixation with splints and plaster after closed reduction is a effective method in treatment of distal fractures of radius in elderly patients, which can more overcome redisplacement of distal fractures of radius, recover function of wrist joint.