手法复位与切开复位治疗桡骨远端不稳定骨折的临床观察

目的探讨手法复位与切开复位治疗桡骨远端不稳定骨折的临床疗效。方法选取符合标准的患者60例，随机分为观察组和对照组各30例，观察组应用切开复位治疗，对照组应用手法复位治疗，比较二者临床疗效。结果两组患者术后均随访12～18个月，观察组完全愈合13例、延迟愈合16例和不愈合1例；对照组完全愈合11例、延迟愈合17例和不愈合2例，差异无统计学意义（P〉O．05）。观察组Jakim评分优良率90．00％，明显高于对照组的73．33％，差异有统计学意义（P〈0．05）。观察组在x线测量桡骨短缩程度优于对照组，差异有统计学意义（P〈0．05），二者在尺偏角及掌倾角方面比较，差异无统计学意义（P〉0．05）。二者并发症发生率相似，差异无统计学意义（P〉0．05）。结论桡骨远端不稳定骨折切开复位治疗结局优于手法复位，是治疗桡骨远端不稳定骨折的有效方法之一。

The Clinical Observation of Manual Reduction and Open Reduction for Distal Radius Unstable Fractures

Objective To study the clinical observation of manual reduction and open reduction for distal radius unstable fractures. Methods Select 60 standard patients, randomly divided into observation group and control group each with 30 cases, the observation group were treated by open reduction, the control group were treated by manual reduction, compare the clinical curative effect. Results Patients of the two groups were followed up for 12 - 18 months postoperatively, in the observation group, 13 cases were completely healed, 16 cases were delayed union, and 1 case didn＇t healed; In control group, 11 cases were completely healed, 17 cases were delayed union, and 2 cases didn＇t healed; healed completely in 11 cases, delayed union of 17 cases and not healing in 2 cases, which didn＇t suggest statistically significance （P 〉 0.05）. Jakim score of the observation group was 90.00%, was obviously higher than that of the control group, which is 73.33%, which suggested statistically significance （P 〈 0.05）. The radial bone shortening degree by X-ray measurement of the observation group is better than that of the control group, which sugge sted statistically significance （P 〈 0.05）, compare the ulnar and palm inclination of the two groups, there didn＇t suggest statistically significance （P 〉 0.05）. The complication incidence of the two groups were similar without statistical significance （P 〉 0.05）. Conclusion The open reduction is superior to the manual reduction for distal radius unstable fractures, which is one of the effective methods for unstable distal radius fracture.