外固定器治疗老年性背伸型粉碎性桡骨远端骨折的病例对照试验

目的：比较分析外固定器固定与小夹板固定在治疗老年背伸型粉碎性桡骨远端骨折的临床疗效。方法：2005年6月至2008年6月治疗背伸型粉碎性桡骨远端骨折74例82侧，外固定器组34例38侧，男27例，女7例；平均年龄（70．05±3．70）岁，行外固定器固定。小夹板组40例44侧，男29例，女11例；平均年龄（70．30±3．48）岁，行小夹板外固定。比较两组患者复位后掌倾角及尺偏角丢失、拆除固定后腕关节功能评分。结果：术后1周，小夹板组即出现掌倾角与尺偏角的丢失（P〈．01）。拆除外固定1个月时，小夹板组与术后当天比较，角度丢失更加明显（P〈0．01）；而外固定器组角度丢失不明显（P〉0．05）。拆除外固后1个月进行腕关节功能评定，外固定器组优于小夹板组（P〈0．05）。结论：治疗老年背伸型粉碎性桡骨远端骨折，宜采用外固定器固定，可减少复位丢失，有利于功能恢复。

Case-control studies on external fixator for the treatment of comminuted distal radius fractures in senile

Objective: To compare and analyze the clinical effects of external fixator and small splint fixator in the treatment of comminuted distal radius fracture in senile. Methods: From 2005.6 to 2008.6,74 senile patients(82 sides) with comminuted distal radius fractures were divided into external fixation group(34 cases 38 sides,27 males and 7 females, with an average of 70.05±3.70 years) and small splint fixation group(40 cases 44 sides,29 males and 11 females,with an average of 70.30±3.48 years). The loss of volar tilting angle and ulnar inclination angle after reduction and the function scores of carpal joint after removing the fixators were compared. Results: One week after surgery,there was loss of volar tilting angle and ulnar inclination in small splint fixation(P<0.01),and one month after removing the external fixator,the loss of angle was more obvious(P<0.01);while the loss of angle in external fixation group was not significant(P>0.05). After one month of removing the fixation,the functional score of wrist joint in external fixation group was obviously higher than that of the small splint fixation group (P<0.05). Conclusion: The external fixator can be adopted to treat comminuted distal radius fractures in senile,which is able to decrease the reduction loss and helpful to functional recovery.