改进夹板固定治疗桡骨远端粉碎性骨折的临床疗效对比研究

目的：改进夹板固定治疗桡骨远端粉碎性骨折,观察其疗效并与传统夹板固定进行放射学比较。方法：92例桡骨远端粉碎性骨折患者,男38例,女54例;年龄23～82岁,平均63岁。按AO分型：A3型15例,C1型40例,C2型26例,C3型11例。患者经手法复位后,治疗组46例以改进夹板及梯形垫超腕掌关节固定,对照组46例以传统夹板方法固定,两组定期摄片复查及换药至骨折临床愈合,拆除夹板后指导功能锻炼。6个月后两组患者参照Gart-land!Werlley腕关节功能评分标准进行疗效评分,放射学疗效按Lidstrom分级法比较。结果：腕关节功能评分,治疗组平均（4.0±2.6）分,优13例,良24例,可9例,优良率为80.6%;对照组平均（6.0±4.2）分,优9例,良19例,可18例,优良率60.9%。放射学评级,治疗组：Ⅰ级32例,Ⅱ级10例,Ⅲ级4例;对照组：Ⅰ级22例,Ⅱ级16例,Ⅲ级8例。结论：通过改进夹板治疗桡骨远端粉碎性骨折较传统夹板方法为好。

To compare and research the clinical effect of treating the comminute distal radius fractures by refining splintage

Objective: To treat the comminute distal radius fractures by improved splint,and obersve the curative effect and compare the radiology with the traditional splint. Methods: Ninety-two patients with distal radius comminute fracture w- ere randomly divided into two groups. There were 38 males and 54 females. The average age was 63 years old ranging from 23 to 82. Acording to AO classification on the distal fracture of the radius,there were 15 cases of A3,40 cases of C1,26 cases of C2 and 11 cases of C3. After all patients were treated by manipulative reduction,46 cases of the treatment group were fixed supra-carpometacarpal joints by improved splint and trapezoid pad,the other 46 cases of control group were tr- eated with the traditional spilint. Both groups were regularly taken X-ray recheck and changed dressings to obtain the clinical cicatrization. Patients were guided to do functional exercise after splints were taken off. Six weeks later all patients were evaluated the curative and radiologic effect according to Gartland-Werlley wrist score and Lidstrom grade respectively. Results: According to wrist score,there were 13 cases on excellent,34 cases on fine and 9 cases on normal in treatment group,which average score was(4.0±2.6)and the percent of wrist functional fitness was 80.6%. There were 9 cases on excellen,19 cases on fine and 18 cases on normal in control group,which average score was(6.0±4.2)and the percent of wrist functional fitness was 60.9%. Acoording to radiology grade,there were 32 cases on the first grade,10 cases on the second grad and 4 cases on the third grade in treatment group. There were 22 cases on the first grade,16 cases on the second grad and 8 cases on the third grade in control group. Conclusion: The outcome of improved splint was better than that of traditional splint on the function and radiology for treating the comminute distal radius fracture.