| 杨傲飞,邹季,何承建.外固定支架结合小夹板固定分阶段治疗老年桡骨远端骨折的临床疗效.骨科,2018,9(4): 279-284. |
| 外固定支架结合小夹板固定分阶段治疗老年桡骨远端骨折的临床疗效 |
| Efficacy and clinical significance of external fixator combined with small splint fixation for phased treatment of aged distal radius fractures |
| 投稿时间：2018-02-07 |
| DOI：10.3969/j.issn.1674-8573.2018.04.005 |
| 中文关键词: 桡骨骨折 外固定器 小夹板 康复 |
| 英文关键词: Radial fractures External fixators Small splint Rehabilitation |
| 基金项目:国家卫生计生委医药卫生科技发展研究中心研究课题（W2013ZT120） |
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| 中文摘要: |
| 目的 探讨急诊行外固定支架治疗的C型桡骨远端骨折病人术后早期去除外固定支架，改用小夹板外固定的临床疗效。方法 对2012年3月至2015年3月于湖北省中医院急诊行外固定支架固定治疗的90例C型桡骨远端骨折病人的临床资料进行回顾性分析，按术后外固定支架的固定时间分为小夹板组和对照组。小夹板组44例，男17例，女27例；年龄为62~85岁，平均70.5岁；急诊采用外固定支架固定，术后3~4周去除外固定支架而改用小夹板继续固定2~3周。对照组共46例，男16例，女30例；年龄为61~87岁，平均71.3岁；急诊采用外固定支架固定，术后6~7周去除外固定支架。比较两组病人术后6、12个月的Gartland-Werley评分及病人满意率。结果 随访12~36个月，平均23.6个月。术后6个月，小夹板组和对照组的Gartland-Werley评分分别为（3.67±2.68）分、（4.12±2.64）分，优良率分别为88.64%、86.96%；术后12个月，小夹板组和对照组的评分分别为（2.99±2.18）分、（3.44±2.76）分，优良率分别为95.45%、93.48%，两组的Gartland-Werley评分、优良率比较，差异均无统计学意义（P均＞0.05）。小夹板组和对照组术后7周的治疗满意率分别为90.91%（40/44）、65.22%（30/46），差异有统计学意义（χ2=8.588，P=0.003）。结论 采用外固定支架结合小夹板外固定分阶段治疗C型桡骨远端骨折，临床疗效满意，提高了病人满意度，是一种可靠的治疗选择。 |
| 英文摘要: |
| Objective To explore the clinical effect of external fixation with splint in type C (AO type) distal radius fractures treated with external fixation in early stage. Methods From March 2012 to March 2015, a retrospective study was performed on 90 patients with type C distal radius fractures treated with external fixation. Patients with distal radius fracture were divided into splint group and control group according to the different fixation durations of external fixation. A total of 44 cases served as splint group, including 17 males and 27 females, aged 62 to 85 years (mean 70.5 years). The external fixation was used at emergency, and 3 to 4 weeks later, the external fixation was removed and splint fixation was given for 2 to 3 week. A total of 46 cases were enrolled in control group, including 16 males and 30 females, aged 61 to 87 years (mean 71.3 years). The external fixation was used at emergency, and 6 to 7 weeks, the external fixation was removed. Gartland-Werley scores were compared between the two groups at 6th and 12th month after surgery. Results All patients were followed up for 12 to 36 months (mean 23.6 months). At 6th and 12th month after operation, the clinical curative effect was evaluated according to Gartland-Werley score. At 6th month, the score in the splint group was 3.67±2.68, and the excellent and good rate was 88.64%. The score in the control group was 4.12±2.64, and the excellent and good rate was 86.96%. At 12th month, the score in the splint group was 2.99±2.18, and the excellent and good rate was 95.45%. The score in the control group was 3.44±2.76, and the excellent and good rate was 93.48%. There was no significant difference in Gartland-Werley score between the two groups (P＞0.05). The satisfaction rate in the splint group was 90.91%, which was significantly higher than 65.22% in the control group (χ2=8.588, P=0.003). Conclusion For type C distal radius fractures, external fixation combined with splint fixation has achieved good clinical efficacy and improved patient comfort and satisfaction during treatment, which is a reliable treatment option. |
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