桡骨远端粉碎性骨折动态及静态外固定支架治疗疗效分析

目的探讨外固定治疗桡骨远端粉碎性骨折的临床疗效,比较动态外固定和静态外固定的疗效差异。方法选择2007年1月～2010年12月我院收治的桡骨远端粉碎性骨折患者78例为研究对象,按收治日期随机分为动态外固定组（46例）,即外固定支架固定3周后对球面关节进行部分解锁、允许腕关节活动;静态外固定组（32例）,为外固定支架球面关节一直锁定、腕关节固定。两组患者均在入院后2天内行手法复位、外固定支架固定,部分患者加植骨及克氏针固定;外固定架固定6～8周,骨折愈合后拆除。术后6个月采用Dienst评定标准评估腕关节功能。结果外固定支架治疗桡骨远端粉碎性骨折有较高的优良率,动态固定组患者临床疗效优良率为91.30%,显著优于静态固定组患者（P〈0.05）。结论动态外固定治疗桡骨远端骨折固定可靠、功能锻炼早及恢复满意,值得临床推广应用。

Effects of comminuted distal radius fractures treated by static and dynamic external fixation

Objective To investigate the effect of external fixation in treating patients with comminuted distal radius fractures,and to compare the functional outcomes of dynamic external fixation and static external fixation.Methods Totally 78 cases of comminuted distal radius fractures admitted into our hospital from Jan.2007 to Dec.2010 were analyzed.They were randomly divided into static external fixation group(32 cases),and dynamic external fixation group(46 cases).The injured wrist of the dynamic fixation group was partially unlocked and allowed wrist joint activity after 3 weeks for external fixation.The wrist was fixed all the time in the static external fixation group.All surgeries were performed within 48 hours of admission.All patients were managed with closed reduction and applied external fixator(Orthofix),supplied bone graft and K-wires fixation to stabilize the fracture if necessary.The fixator was maintained for 6-8 weeks and was removed after bone healing.The functional outcome was assessed using Dienst score at 6 months after operation.Results Dynamic and static external fixators both achieved good outcomes for patients with comminuted distal radius fractures,and the clinical curative effect of dynamic external fixation group was better than that of static external fixation group(P<0.05).Conclusion External fixation for treating patients with comminuted distal radius fractures has good curative effect,with advantages of reliable fixation,early functional exercise and satisfactory recovery.Dynamic external fixation is worthy to be widely applied in clinic.