目的 探讨C3型桡骨远端骨折两种手术方法的差异。方法 回顾性分析武警新疆总队医院2019-03至2021-06治疗的C3型桡骨远端骨折患者(49例)临床资料,其中外固定支架联合克氏针治疗28例(支架组),T形钢板治疗21例(钢板组)。术后以最后一次随访结果为准,对两组患者患侧尺偏角和掌倾角进行影像学测量评估,同时对患侧腕关节主动活动度进行测量统计,并采用PRWE评分了解患肢功能对患者日常生活的影响程度及患者对疗效的满意度。结果 收治患者均获随访,随访时间12个月。支架组尺偏角(22.23°±1.36°)恢复情况优于钢板组(21.09°±1.19°),两者差异具有统计学意义(P＜0.05);支架组术后腕关节活动度比较尺偏角度为(27.04°±2.58°),大于钢板组(25.24°±3.07°),差异具有统计学意义(P＜0.05);支架组PRWE评分为(17.21±4.78)分,钢板组为(20.71±5.58)分,差异也具有统计学意义(P＜0.05)。结论 对C3型桡骨远端骨折采用外固定支架联合克氏针的方式进行手术治疗有助于尺偏角及尺偏功能的恢复,可达到良好的临床满意度,且术中操作灵活,对粉碎程度较严重的病例具有一定优势,值得临床采用。
Abstract
Objective To investigate the difference of two surgical methods for C3 distal radius fractures.Methods Clinical data of 49 patients with C3 distal radius fractures treated at Xinjiang Autonomous Regional Corps Hospital of Chinese People's Armed Police Force from March 2019 to June 2021 were retrospectively analyzed. Among them, 28 cases were treated with external fixation brackets combined with Kirschner wires (stent group) and 21 cases were treated with T-plate (plate group). Based on the results of the last follow-up after surgery, imaging measurements were conducted to evaluate the ulnar deviation angle and palmar inclination angle of the affected side of the two groups of patients, and the active range of motion of the affected side was measured and statistically analyzed. PRWE score was used to understand the impact of the function of the affected limb on the patient's daily life and the patient's satisfaction with the therapeutic effect.Results All patients were followed up for 12 months. The recovery of ulnar deviation angle (22.23°±1.36°) in the stent group was better than that in the steel plate group (21.09°±1.19°), and the difference was statistically significant (P<0.05). The postoperative ulnar deviation angle of the wrist joint in the stent group (27.04°±2.58°) was greater than that in the steel plate group (25.24°±3.07°), and the difference was statistically significant (P<0.05). The PRWE score of the stent group was (17.21±4.78), and that of the steel plate group was (20.71±5.58), with statistically significant difference (P<0.05).Conclusions The surgical treatment of C3 distal radius fractures with external fixation brackets combined with Kirschner wires can help restore the ulnar deviation angle and ulnar deviation function, achieve good clinical satisfaction, and is characterized by flexible intraoperative operation method, which has certain advantages for cases with high degree of comminution and is worthy of clinical use.
关键词
桡骨远端 /
粉碎骨折 /
外固定支架 /
钢板内固定
Key words
distal radius /
comminuted fracture /
external fixation /
plate internal fixation
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