两种方法治疗桡骨远端不稳定骨折的疗效比较

目的比较桡骨远端（斜）T形钢板内固定和闭合复位石膏外固定两种方法治疗桡骨远端不稳定性骨折的效果。方法对2002年3月-2007年3月间的不稳定型骨折96例103侧进行分析，其中钢板内固定42例45侧，其余为手法复位石膏外固定。结果随访12～63个月，平均33．5个月。按Dienst功能评分标准评定，钢板内固定组的优良率是86．67％，其中A2，A3型为92．31％，B，C型是84．38％；手法复位石膏外固定组则分别为71％，88．20％，63．40％。两组的A2，A3型比较差异无显著性意义（P〉0．05），B，C型组间比较差异有显著性意义（P〈0．05）。结论对A2，A3型骨折，两种治疗方法优良率差别不大；对B，C型骨折，（斜）T形钢板内固定治疗的效果要优于闭合复位石膏外固定。

Comparison study for treatment of unstable distal radius fractures with two methods

Objective To compare the clinical results of internal fixation with T-shaped plate and closed reduction with application of plaster in treatment of unstable distal radius fractures.Methods A total of 96 patients（103 cases） with unstable distal radius fractures during March 2002 to March 2007 were collected and analyzed retrospectively. Among them 42 patients （45 sides） were treated by internal fixation with T-shaped plate, and the others by closed reduction and external fixation with plaster.Results All patients were followed up with the average 33.5 months （range 12 to 63months）. According to the Dienst criteria, the excellent and good rate in plate internal fixation group was 86.67%, of which the type A2 ＆ A3 is 92.31% and type B ＆ C is 84.38%. On the other hand, the number in group of closed reduction and external fixation is 71%,88.20%,63,40% respectively, Furthermore, the difference between type A2 ＆ A3 in two groups has no statistically significance （P 〉0,05）,however, it has statistically significance between type B ＆ C in two groups （P 〈0.05）,Conclusion No statistical difference between these two methods in treating the type A2 ＆ A3 fractures was found, However, the outcome is better in the T-shaped plate internal fixation group than in the closed reduction and external fixation group to type B ＆ C fractures.