植骨内固定与闭合复位支架外固定治疗桡骨远端C型骨折疗效比较

目的：比较植骨内固定与闭合复位支架外固定治疗桡骨远端C型骨折的临床疗效。方法对38例桡骨远端C型骨折患者分别采用植骨内固定(17例)与闭合复位支架外固定(21例)治疗。比较两组术后影像学指标，腕关节功能按Gartland-Werley功能评分标准进行评价。结果患者均获得随访，时间6~18个月。术后3个月掌倾角、桡骨高度内固定组均优于外固定组，差异均有统计学意义( P<0．05)。末次随访腕关节背伸、掌屈、旋前、旋后及 Gartland-Werley 功能评分内固定组均优于外固定组，差异均有统计学意义( P <0．05)。腕关节功能评估：内固定组优6例，良9例，可2例，优良率15/17；外固定组优4例，良10例，可5例，差2例，优良率14/21；两组差异有统计学意义(P<0．05)。结论植骨内固定治疗桡骨远端C型骨折能达到理想复位，能有效防止骨折复位丢失和再移位，临床疗效优于闭合复位支架外固定。

Comparison of the curative effect between bone autograft with internal fixation and closed re-duction with external fixator in treatment of type C distal radius fractures

Objective To compare the clinical effect of the oblique T-plate plus bone grafting and close reduction plus external fixator in the treatment of type C fracture of distal radius. Methods Thirty-eight cases with type C distal ra-dius fractures were treated by internal fixation (n=17), with bone graft and external fixator (n=21). Postoperative radiographic parameters, wrist function by Gartland-Werley score evaluation criteria were compared. Results Pa-tients were followed up for 6~18 months. Within 3 months after surgery, internal fixation group with volar tilt, radial height was superior to external fixation group, the differences were statistically significant (P<0. 05). At the last fol-low-up, internal fixation group of wrist dorsiflexion, palmar flexion, pronation, supination and Gartland-Werley score were better than external fixation group, the differences were statistically significant (P<0. 05). Wrist function as-sessment:internal fixation group was excellent in 6 cases, good in 9,fair in 2, excellent-good rate was 15/17;exter-nal fixation group was excellent in 4 cases, good in 10, fair in 5 and poor in 2, excellent-good rate was 14/21. Ex-cellent-good rate between the two groups was statistically significant (P<0. 05). Conclusions Internal plating plus bone grafting may result in better results than close reduction plus external fixator for type C fracture of distal radius. It can effectively prevent the loss of reduction and fracture displacement.