钢板内固定治疗桡骨远端骨折是否合并尺骨茎突骨折对预后影响的病例对照研究

目的 :研究AO分型C型桡骨远端骨折伴或不伴尺骨茎突骨折对预后的影响。方法 :通过病历查询及随访获取资料,将2006年7月至2011年7月在北京大学人民医院治疗的76例AO分型C型桡骨远端骨折患者分为未合并尺骨茎突骨折组(56例)和合并尺骨茎突骨折组(20例),未合并尺骨茎突骨折组行切开复位内固定术治疗,合并尺骨茎突骨折组行切开复位钢板内固定治疗,对合并的尺骨茎突骨折未予固定。记录患者的一般资料、是否植骨、关节活动度、Gartland&Werley功能评分及影像学评分,比较两组患者治疗情况及疗效。结果:合并尺骨茎突骨折组患者尺侧疼痛较未合并尺骨茎突骨折组患者明显。骨折部位的疼痛、腕关节掌屈、腕关节背屈、主动活动时疼痛、桡偏、尺偏、前臂旋前、前臂旋后、Gartland&Werley功能评分和影像学评分,未合并尺骨茎突骨折组分别为(0.1±0.1)分,(51.1±1.9)°,(60.2±1.9)°,(0.6±0.1)分,(23.1±0.9)°,(28.7±1.3)°,(81.5±2.6)°,(68.2±2.7)°,(1.9±0.3)分,(89.6±12.3)分;合并尺骨茎突骨折组分别为(0.3±0.3)分,(51.4±2.3)°,(66.6±1.7)°,(0.5±0.2)分,(24.5±2.0)°,(26.9±1.8)°,(80.3±2.5)°,(70.3±3.7)°,(1.2±0.4)分,(92.5±7.5)分。以上各项指标两组差异均无统计学意义。结论 :是否合并尺骨茎突骨折不影响钢板内固定治疗桡骨远端骨折的关节活动度及功能。

Case-control study on effects of fracture of processus styloideus ulnae on prognosis after plate fixation for the treatment of distal radial fractures

Objective:To analyze effects of fracture of processus styloideus ulnae on prognosis in the treatment of distal radial fracture of type C according to AO classification. Methods:This was a retrospective case-control study,and the information was got ten through case evaluation and follow-up,including sex,age,patient satisfaction,Gartland & Werley score and radiographic score. There were 76 patient treated with open reduction and plate fixation in People's Hospital Affiliated to Peking University from July 2006 to July 2011. All the patients were divided into two groups:no combination with fracture of processus styloideus ulnae(group A,56 cases),combination with fracture of processus styloideus ulnae(group B,20 cases). The patients in group A and B were treated with open reduction and internal fixation;however the fracture of processus styloideus ulnae was not fixed. The indexes such as clinical data,bone grafting,joint movement,Gartland & Werley score and radiographic score were compared between two groups. Results:The ulnaris pain of patients in group B was more obvious than that in group A. The local VAS,palmar and dorsal flexion degree of wrist joint,motion VAS,patients satisfaction score,radial and ulnar deviation degree,pronation and supination of forearm degree,Gartland & Werley score and radiographic score were separately 0.1±0.1,(51.1±1.9)°,(60.2±1.9)°,0.6±0.1(23.1±0.9)°,(28.7±1.3)°,(81.5±2.6)°,(68.2±2.7)°,1.9±0.3,89.6±12.3 in group A; and separately 0.3±0.3,(51.4±2.3)°,(66.6±1.7)°,0.5±0.2,(24.5±2.0)°,(26.9±1.8)°,(80.3±2.5)°,(70.3±3.7) °,1.2±0.4,92.5±7.5 in group B;there were no statistical differences in above indexes between two groups. Conclusion:Whether the distal radial fracture with a concomitant unrepaired ulnar styloid fracture or not exerts no influence on mainly outcomes including function,radiography and motion of the wrist.