锁定加压钢板与克氏针结合外固定支架治疗桡骨远端复杂关节内骨折的解剖复位及关节功能恢复对比

目的比较锁定加压钢板与克氏针联合支架外固定对桡骨远端复杂关节内骨折解剖复位及功能恢复的效果。方法对收治的桡骨远端关节内骨折患者进行回顾性分析,筛选获得1年以上随访病人80例,根据手术方法不同分为两组,A组38例采用锁定加压钢板进行治疗;B组42例采用克氏针联合支架进行外固定术治疗。结果两组术后愈合及并发症组间比较差异无统计学意义（P＞0.05）。两组患肢缩短均达到解剖复位效果,组间比较差异无统计学意义（P＞0.05）。腕功能恢复：C1、C2型骨折患者两组效果差异无统计学意义（P＞0.05）;C3型骨折患者B组效果优于A组（P〈0.05）。结论对于桡骨远端复杂关节内骨折的治疗中C1、C2型骨折,锁定加压钢板治疗与克氏针联合支架外固定治疗都可作为一种选择,无优劣之分;C3型骨折,克氏针联合支架外固定的治疗效果比锁定加压钢板效果好,可作首选治疗方式。

Restoration of joint function and anatomic reduction of complex intra-articular fractures of distal radius treated with locking compression plate and external fixation combined with Kirschner wire

Objective To compare restoration of joint function and anatomic reduction of complex intra-articular fractures of distal radius treated with locking compression plate and external fixation combined with Kirschner wire.Methods 80 patients with complex intra-articular fractures of distal radius were divided into two groups according to the different surgical methods.Group A（42cases）was treated with locking compression plate and Group B（38cases）was treated with external fixation combined with Kirschner wire.Results There was no significant difference on healing and complications between the two groups after the surgery（P〉0.05）.There was no significant difference of anatomic reduction effect between the two groups（P〉0.05）.There was no significant difference of wrist functional recover on C1,C2 fractures between the two groups（P〉0.05）.The wrist functional recover on C3 type fracture in group B was better than that group A（P〈0.05）.Conclusion The two method have same effect on the C1 and C2 fractures patients,but on the C3 fractures patients the Kirschner combined with external fixation has a better effect.