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投稿时间:2020-01-15 网络发布日期:2020-08-20
投稿时间:2020-01-15 网络发布日期:2020-08-20
中文摘要: 目的 比较持续牵引下闭合复位克氏针固定与锁定加压钢板内固定治疗不稳定性桡骨远端骨折的疗效。方法 回顾性分析2017年8月至2019年1月桡骨远端骨折60例患者的临床资料,采用掌侧锁定钢板内固定30例为钢板内固定组,采用闭合复位克氏针固定的30例为克氏针固定组。观察两组术中出血量、手术时间及并发症发生情况。术后门诊复查腕关节正侧位片,比较腕关节屈伸活动角度。采用Gartland-werley腕关节评分系统[2]对腕关节活动功能进行测定。结果 克氏针固定组手术时间短于钢板内固定组,术中出血量少于钢板内固定组,差异有统计学意义(P<0.01)。两组患者均获随访6~12个月,无死亡病例。锁定钢板内固定组中有1例术中桡动脉破裂,术中给予动脉吻合,随访无血供异常。所有患者术后随访X线片显示骨折端均达到骨性愈合,后期无迟发感染发生。两组腕关节活动度(掌屈、背伸)以及腕关节活动功能比较无统计学差异(P>0.05)。结论 持续牵引闭合复位克氏针固定与锁定钢板内固定治疗不稳定桡骨远端骨折均能获得较好临床效果,前者在术中出血、手术时间方面存在优势,两者在骨折复位、腕关节功能恢复方面效果相当。
中文关键词: 桡骨远端骨折,不稳定性 持续牵引 闭合复位克氏针 锁定加压钢板 腕关节活动功能
Abstract:ObjectiveTo compare the long-term effects of closed reduction and kirschner wire fixation under continuous traction and locking compression plate internal fixation in the treatment of unstable distal radius fractures.MethodsSixty patients with unstable distal radius fractures operated from August 2017 to January 2019 were selected,including 30 patients receiving closed reduction and kirschner wire internal fixation (kirschner group) and 30 patients undergoing volar locking plate internal fixation (plate group).Intraoperative bleeding,operation time,complications and wrist extension angle were observed and compared between two groups.Gartland-Werley wrist score was used to evaluate the function of the wrist joint.ResultsCompared with plate group,the operation time,intraoperative blood loss significantly decreased in Kirschner group(P<0.01).All the patients were followed up for 6 to 12 months without death.In plate group,there was one case with radial artery ruptured and anastomosed during operation,and no abnormal blood supply was found during the follow-up.X-ray film showed that all patients achieved bony healing at the fracture ends,and no late infection occurred at the later stage.There were no statistical differences in Gartland-Werley score for wristpalmar flexion and dorsiflexion and wrist movement function between two groups (P>0.05).ConclusionsBoth closed reduction Kirschner wire fixation with continuous traction and locking plate internal fixation can achieve better clinical results in the treatment of unstable distal radius fractures.The former has more advantages in reducing the intraoperative bleeding and operation time.
keywords: Distal radius fracture,unstable Continuous traction Closed reduction kirschner wire Locking compression plate Wrist movement function
文章编号: 中图分类号: 文献标志码:B
基金项目:安徽省从庆武名老中医工作室项目(2100601)
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引用文本:
刘磊,徐文联,李华杰,等.两种固定方式治疗不稳定性桡骨远端骨折疗效比较[J].中国临床研究,2020,33(8):1054-1057.
刘磊,徐文联,李华杰,等.两种固定方式治疗不稳定性桡骨远端骨折疗效比较[J].中国临床研究,2020,33(8):1054-1057.