手术和石膏外固定治疗桡骨远端不稳定骨折的效果对比
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摘要
目的探究手术和石膏外固定对于桡骨远端不稳定骨折的治疗效果,指导临床应用。方法 100例桡骨远端不稳定骨折患者,随机分为观察组和对照组,各50例。观察组患者应用手术治疗,对照组患者接受石膏外固定治疗。比较两组患者术后1年患肢活动情况,术后1年影像学恢复情况,术后1年功能恢复情况,术后1、3、6个月及1年的疼痛视觉模拟评分法(VAS)评分。结果术后1年,观察组患者的背伸、掌曲、旋后及旋前活动度分别为(65.25±11.35)、(64.32±11.40)、(74.29±11.46)、(69.24±12.16)°,均显著优于对照组的(41.64±10.53)、(43.62±9.78)、(43.51±13.59)、(47.22±10.69)°,差异均具有统计学意义(P<0.05)。影像学检查,观察组患者的尺偏角、掌倾角和桡腕关节面平整度分别为(18.46±4.16)°、(11.35±3.76)°、(1.73±0.54)mm,均显著优于对照组的(14.53±4.67)°、(8.57±4.05)°、(2.62±0.63)mm,差异均具有统计学意义(P<0.05)。观察组优良率为84.00%,高于对照组的64.00%,差异有统计学意义(P<0.05)。观察组术后1、3个月的VAS评分分别为(2.10±0.42)、(1.86±0.32)分,显著低于对照组的(3.68±0.37)、(2.64±0.35)分,差异均具有统计学意义(P<0.05)。结论桡骨远端不稳定骨折患者接受手术治疗,其治疗效果较石膏外固定更佳,疼痛较轻且活动度明显较高。
Objective To investigate the effect of surgery and plaster external fixation on unstable distal radius fracture, and to guide clinical application. Methods A total of 100 patients with unstable distal radius fractures were randomly divided into observation group and control group, with 50 cases in each group. The observation group was treated with surgery, and the control group was treated with plaster external fixation. Comparison were made on activity of the affected limb, imaging recovery, functional recovery of 1 year after operation, visual analogue scale(VAS) score of 1, 3, 6 months and 1 year after operation between the two groups. Results At 1 year after operation, the observation group had back extension, palm curvature, supination and pronation activity respectively as(65.25±11.35),(64.32±11.40),(74.29±11.46) and(69.24±12.16) °, which were all significantly better than(41.64±10.53),(43.62±9.78),(43.51±13.59) and(47.22±10.69) ° in the control group, and their difference was statistically significant(P<0.05). According to imaging examination, the observation group had ulnar deviation angle, palmar inclination angle and radiocarpal articular surface smoothness respectively as(18.46±4.16) °,(11.35±3.76) ° and(1.73±0.54) mm, which were all significantly better than(14.53±4.67)°,(8.57±4.05)° and(2.62±0.63) mm in the control group, and their difference was statisticallysignificant(P<0.05). The observation group had higher excellent rate as 84.00% than 64.00% in the control group, and the difference was statistically significant(P<0.05). The observation group had VAS score at 1 and 3 months after operation respectively as(2.10±0.42) and(1.86±0.32) points, which were significantly lower than(3.68±0.37) and(2.64±0.35) points in the control group, and their difference was statistically significant(P<0.05). Conclusion In the treatment of unstable distal radius fracture, surgical treatment shows better effect than that of plaster external fixation with mild pain and higher range of motion.
Objective To investigate the effect of surgery and plaster external fixation on unstable distal radius fracture, and to guide clinical application. Methods A total of 100 patients with unstable distal radius fractures were randomly divided into observation group and control group, with 50 cases in each group. The observation group was treated with surgery, and the control group was treated with plaster external fixation. Comparison were made on activity of the affected limb, imaging recovery, functional recovery of 1 year after operation, visual analogue scale(VAS) score of 1, 3, 6 months and 1 year after operation between the two groups. Results At 1 year after operation, the observation group had back extension, palm curvature, supination and pronation activity respectively as(65.25±11.35),(64.32±11.40),(74.29±11.46) and(69.24±12.16) °, which were all significantly better than(41.64±10.53),(43.62±9.78),(43.51±13.59) and(47.22±10.69) ° in the control group, and their difference was statistically significant(P<0.05). According to imaging examination, the observation group had ulnar deviation angle, palmar inclination angle and radiocarpal articular surface smoothness respectively as(18.46±4.16) °,(11.35±3.76) ° and(1.73±0.54) mm, which were all significantly better than(14.53±4.67)°,(8.57±4.05)° and(2.62±0.63) mm in the control group, and their difference was statisticallysignificant(P<0.05). The observation group had higher excellent rate as 84.00% than 64.00% in the control group, and the difference was statistically significant(P<0.05). The observation group had VAS score at 1 and 3 months after operation respectively as(2.10±0.42) and(1.86±0.32) points, which were significantly lower than(3.68±0.37) and(2.64±0.35) points in the control group, and their difference was statistically significant(P<0.05). Conclusion In the treatment of unstable distal radius fracture, surgical treatment shows better effect than that of plaster external fixation with mild pain and higher range of motion.
引文
[1]高金伟,吴斗.金属植入物固定与修复新鲜不稳定型桡骨远端骨折合并腕舟状骨骨折:半年随访.中国组织工程研究, 2016,20(13):1880-1887.
[2]宁仁德,姚涛,孔令超,等.掌背侧联合入路手术治疗桡骨远端AOC3型骨折.中国骨与关节损伤杂志, 2015, 30(9):948-950..
[3]周德杰,田军,徐军,等.两种不同内固定方法治疗背侧移位桡骨远端C型骨折疗效分析.中国矫形外科杂志, 2014, 22(6):481-486.
[4]林奋强,蔡学海,林奋越.外固定支架与钢板内固定治疗桡骨远端不稳定型骨折的疗效比较.海南医学, 2014, 12(5):656-658.
[5]廖志光.关节功能锻炼配合中药熏洗治疗桡骨远端骨折的临床效果观察.北方药学, 2016, 13(4):31-32.
[6]谢正虎,董霞,袁荣霞,等.手法复位夹板外固定与切开复位钢板内固定治疗老年桡骨远端C型骨折的比较研究.中医正骨, 2016, 28(10):18-23.
[7]温建民,毕春强,桑志成,等.外固定器与锁定加压钢板治疗桡骨远端骨折的临床疗效观察.中国矫形外科杂志, 2011,19(2):106-108.
[8]张运昌.桡骨远端不稳定骨折给予手术与石膏外固定治疗的临床对比.中国现代医生, 2018, 56(8):67-69.
[2]宁仁德,姚涛,孔令超,等.掌背侧联合入路手术治疗桡骨远端AOC3型骨折.中国骨与关节损伤杂志, 2015, 30(9):948-950..
[3]周德杰,田军,徐军,等.两种不同内固定方法治疗背侧移位桡骨远端C型骨折疗效分析.中国矫形外科杂志, 2014, 22(6):481-486.
[4]林奋强,蔡学海,林奋越.外固定支架与钢板内固定治疗桡骨远端不稳定型骨折的疗效比较.海南医学, 2014, 12(5):656-658.
[5]廖志光.关节功能锻炼配合中药熏洗治疗桡骨远端骨折的临床效果观察.北方药学, 2016, 13(4):31-32.
[6]谢正虎,董霞,袁荣霞,等.手法复位夹板外固定与切开复位钢板内固定治疗老年桡骨远端C型骨折的比较研究.中医正骨, 2016, 28(10):18-23.
[7]温建民,毕春强,桑志成,等.外固定器与锁定加压钢板治疗桡骨远端骨折的临床疗效观察.中国矫形外科杂志, 2011,19(2):106-108.
[8]张运昌.桡骨远端不稳定骨折给予手术与石膏外固定治疗的临床对比.中国现代医生, 2018, 56(8):67-69.