中老年桡骨远端骨折两种治疗方法临床疗效比较

目的：研究中老年桡骨远端骨折单纯手法复位石膏外固定与手法复位经尺骨交叉克氏针内固定加石膏托外固定2种治疗方法的临床疗效。方法：我院2000年8月～2005年10月收住46岁以上桡骨远端骨折145例。AO分型：A型37例。B型30例，C型78例，113例采用单纯于法复位石膏固定术（石膏固定组），32例采用手法复位经尺骨交叉克氏针内固定加石膏托外固定术（克氏针内固定＋石膏托外固定组），随访比较2组临床疗效。结果：所有患者随访5～18个月，平均11．5个月，按照Dienst疗效评价标准，手法复位经石膏固定组优良率为62．8％，手法复位经尺骨交叉克氏针内固定加石膏托外固定组优良率为87．5％。结论：手法复位经尺骨交叉克氏针内固定加石膏托外固定治疗桡骨远端骨折具有操作简单、创伤小、治疗效果可靠等优点，为治疗中老年桡骨远端骨折的有效方法。

Treatments of senile distal radial fractures: a comparative research of their clinical results

Objective: To compare the clinical effects between manual reduction with plaster immobilization and limited internal fixation combined with plaster in management of elderly patients with distal radius factures. Methods: From August 2000 to October 2005, 145 patients with distal radius fracture were treated in our department.According to AO classification, 37 cases were type A, 30 in cases type B and 78 cases in type C. One hundred and thirteen cases were treated with manual reduction and plaster immobilization, 32 cases with limited internal fixation combined with plaster. Results: Follow-up duration ranged from 5 to 18 months with an average of 11.5 months. According to Dienst criteria, the excellent rate of functional outcome was 62.8% for manual reduction and plaster immobilization, 87.5% for the latter. Conclusion: limited internal fixation combined with plaster is reliable and effective in treatment of elder patients with distal radius fractures.