动力性外固定支架和闭合复位治疗桡骨远端关节内移位骨折的疗效比较

目的 回顾性分析和比较动力性外固定支架(dynamic external fixation，DEF)与闭合复位石膏外固定两者治疗桡骨远端关节内移位骨折的疗效评价。方法 对96例急性桡骨远端关节内移位骨折患者，49例应用动力性外固定支架、47例采用闭合复位石膏外固定治疗。结果 治疗后均随访1年。96例桡骨远端关节内骨折，按AO分型属B型或C型骨折复位评分及Lidstrom功能评分标准评定：(1)石膏固定组：复位评分：优良率为44．7％，一般为36．2％，差者19．1％。功能评分：优良率为46．8％，一般为31．9％，差者21．3％。(2)动力性外固定支架组：复位评分：优良率达95．9％，一般及差仅占4．1％。功能评分：优良率为91．8％，一般及差为8．2％。结论 动力性外固定支架组的复位和功能评分明显优于石膏组，是治疗桡骨远端关节内严重移位、粉碎性骨折的好方法。

Displaced intra-articular fractures of distal radius: a comparative evaluation of results following dynamic external fixation versus closed reduction

Objective To analyze and compare retrospectively the therapeutic results of displaced intra articular fractures of distal radius between by dynamic external fixation(DEF) and by closed reduction and plaster immobilization. Methods Of all 96 cases of acute displaced intra articular fractures of the distal end of the radius, 49 cases were treated with DEF and 47 cases with closed reduction and plaster immobilization.Results The mean follow up was one year. The fracture type of the series belongs to type B and type C according to the classification of AO.The anatomical and functional results were assessed using the scoring system of lidstrom. In the plaster group, anatomical score showed good and excellent rate 44.7%, fair 36.2% and poor 19.1%. Functional score indicated good and excellent rate 46.8%, fair 31.9%, poor 21.3%. In the DEF group, anatomical score was good and excellent rate 95.9%, fair and poor 4.1%. Functional score showed good and excellent rate 91.8%, fair and poor 8.2%. Conclusion Both the anatomical and functional score were significantly superior in the dynamic external fixation group to those in the plaster group. We recommend that severely displaced comminuted intra articular fractures at the distal radial bone should be treated with dynamic external fixator.