两种内固定方法治疗桡骨远端骨折的疗效比较研究

目的 对比斜T型锁定加压接骨板系统(locking compression plate,LCP)及AO普通T型板钉系统治疗桡骨远端骨折的疗效.方法 对1999年3月至2009年12月我科收治的313例桡骨远端骨折患者中获得完整随访资料的72例(73侧),采用Sarmiento改良的Gartland-Werley评分系统(GW评分)进行术后功能评分,并比较LCP(LCP组)及AO普通T型板钉系统(普通组)内固定术后两组腕关节的功能.结果 术后随访时间为3个月至6年,平均25.4个月.X线片显示骨折全部愈合.GW评分LCP组平均1.98分,普通组平均1.43分,两组差异无统计学意义(P>0.05);两组在患者满意度上差异也无统计学意义(P>0.05).结论 对于绝大部分复位失败的桡骨远端A型骨折、移位明显的B型骨折及C型骨折,应用AO普通T型板钉固定就可满足手术需要,而对于骨质疏松严重的粉碎性C型骨折,LCP的内固定效果更为可靠.

Comparison of the therapeutic effects of two kinds of internal fixation for distal radial fractures

Objective To compare therapeutic effects of oblique T-locking compression plate system (LCP) and general AO T-plate and screw system for treatment of distal radius fractures. Methods From March 1999 to December 2009, 313 cases of distal radial fractures were treated with LCP or AO T-plate and screw system in our department, were follow-up. Postoperative functional score were performed by Sarmiento modified Gartland-Werley scoring system (GW score) was used to assess the postoperative functions in 72 (73 wrists) cases with complete follow-up. Wrist joint function was compared between patients who underwent LCP fixation (LCP group) and patients who underwent AO T-plate and screw system fixation (routine group).Results Tne follow-up time was 3 months to 6 years, with an average of 25.4 months. Bone union was seen in X-rays of all cases. The average score of the LCP group was 1.98 points, and the AO T-plate and screw system group was 1.43 points. There was no significant difference between the two groups ( P > 0.05), and the differences of patient satisfaction between the two group were not notable either ( P > 0.05). Conclusion AO T- plate and screw system is suitable for majority of type A fractures with failed manipulative reduction, type B fractures with obvious displacement, and type C fractures. LCP fixation is more reliable for type C comminuted fractures with osteoporosis.