不同内固定对前臂骨折愈合及功能的影响

为了解新鲜尺桡骨骨折手术治疗中不同手术入路、内固定物及术后功能锻炼对骨折愈合及前臂功能恢复的影响,对采用手术切开复位内固定术治疗的136例新鲜尺桡骨骨折进行了回顾性分析,其中尺桡骨均采用钢板内固定者66例(A组),尺骨采用克氏针固定、桡骨采用钢板内固定者70例(B组).结果显示尺骨骨折临床愈合率A组比B组明显提高,差异有显著性(P＜0.05);前臂功能恢复A组比B组好,差异有显著性(P＜0.05).骨折愈合与内固定物关系:6孔钢板内固定组与4、8孔钢板及克氏针内固定等相比骨折愈合率有明显提高,差异有非常显著性(P＜0.01).提示尺桡骨骨折均采用钢板内固定较尺骨克氏针、桡骨钢板内固定疗效好,而采用6孔钢板固定桡骨相对骨折愈合较好.

THE INFLUENCE OF DIFFERENT INTERNAL FIXATORS ON FRACTURE HEALING AND FUNCTION RECOVERY OF THE FOREARM

The aim of the paper is at explore the influence of different surgical approaches and internal fixators and postoperative functional exercises in the surgical treatment of fresh ulnar and radial fractures on fracture healing and functional recovery of the forearm. One hundred and thirty-six cases of fresh ulnar and radial fractures treated by open reduction and internal fixation were retrospectively analyzed. Of 136 cases, 66 cases had both ulnas and radii fixed by plates (Group A) and 70 cases had the ulnas fixed by Kirschner pins and the radii fixed by plates (Group B). The results showed that Group A had an obvious advantage over Group B in the clinical ulnar-fracture healing rate and the forearm functional recovery with a significant difference (P < 0.05). The relationship between fracture healing and internal fixators suggested that the 6-pore-plate internal fixation had a significant advantage over the 4- or 8-pore-plate and Kirschner pin internal fixation in the significant improvement of fracture healing rate with a significant difference (P < 0.01), suggesting that the therapeutic effect of the plate internal fixation for both ulnar and radial fractures was better than that of the Kirschner pin fixation of the ulna and the plate fixation of the radius; the 6-pore-plate fixation of the radius could relatively more benefit the fracture healing.