骨质疏松性桡骨远端骨折两种治疗方法的疗效比较

目的 比较复位夹板外固定和复位钢板内固定在中老年骨质疏松性桡骨远端骨折中的应用价值.方法 对2008 年1 月至2011 年6 月广东省中医院采用闭合复位夹板固定（夹板组,15 例）和切开复位钢板内固定（钢板组,14 例）治疗的29 例中老年（≥45 岁）单侧桡骨远端闭合骨折骨质疏松性患者的临床资料进行回顾性分析.结果 29 例患者术后均获随访,随访时间6～42 个月,平均随访时间18 个月.两组患者在腕关节患者自行评估（PRWE）量表总评分、疼痛评分以及功能评分方面比较,差异无统计学意义（P ＞0.05）,但费用方面比较,差异有统计学意义（P ＜0.05）.结论 手法复位夹板外固定治疗中老年骨质疏松性桡骨远端骨折患者能够达到与切开复位钢板内固定相似的治疗效果,费用低于后者.

Comparation of clinical effects of two methods for distal radius fractures with osteoporosis

Objective To investigate the difference of therapeutic effects and medical expanse between the conservative treatment(reduction and splint fixation with functional brace)and surgical treatment(reduction and plate internal fixation)for osteoporotic middle-aged and elderly patients with distal radius fractures.Methods Clinical data of 29 patients(≥45 years old)with unilateral distal radius closed fractures treated by reduction and splint fixation with functional brace(splint group,n=15)or open reduction and plate fixation(plate group,n= 14)in Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2008 to June 2011 were analyzed retrospectively.Results The patients were followed up from 6 to 42 months,with an average of 18 months.The wrist pain and function,as well as total score in patient rated wrist evaluation(PRWE)system compared between two groups had no statistical difference(P>0.05),but the difference of hospitalized cost compared between two groups had statistical significance(P<0.05).Conclusion Manipulative reduction andsplint fixation with functional brace for the treatment of osteoporotic middle-aged and elderly patients with distal radius fractures can achieve the similar therapeutic effects as the open reduction and internal fixation,but it is cheaper than the latter.