目的 探讨桡骨远端C型骨折中桡骨高度恢复的重要性及治疗方法的选择.方法 回顾性分析广州中医药大学附属骨伤科医院关节骨科和创伤骨科2013年6月至2015年9月门诊及住院治疗的桡骨远端骨折患者61例,按照国际内固定研究协会(AO/ASIF)骨折分型C1型34例、C2型14例、C3型13例,根据治疗方法将其分为手法复位夹板外固定组(27例)、外固定支架组(18例)、钢板螺钉内固定组(16例),比较各组治疗后的桡骨高度、掌倾角、尺偏角及Gartland-Werley评分(G-W评分).结果 58例患者获得随访.3组桡骨高度、尺偏角及G-W评分比较,差异均有统计学意义(P<0.05),3组掌倾角比较差异无统计学意义(P>0.05).外固定支架组、钢板螺钉内固定组桡骨高度及尺偏角与手法复位夹板外固定组比较,差异均有统计学意义(P<0.05);外固定支架组与钢板螺钉内固定组比较,差异无统计学意义(P>0.05).手法复位夹板固定组G-W评分与外固定支架组比较,差异无统计学意义(P>0.05);钢板螺钉内固定组与手法复位夹板固定组及外固定支架组比较,差异均有统计学意义(P<0.05).结论 桡骨高度的恢复可以较好地恢复尺偏角和改善关节功能.%Objective To study the importance of radial height restoration in the type C distal radial fractures and selection of therapeutic method.Methods Sixty-one cases of type C distal radial fractures in the department of joint orthopedics and traumatic orthopedics of affiliated traumatic and orthopedic hospital of Guangzhou university of Chinese medicine from June 2013 to September 2015 were retrospectively analyzed, including 34 cases of C1 type,14 cases of C2 type and 13 cases of C3 type according to the AO/ASIF fracture classification, the cases were divided into the manual reduction and splint external fixation group (27 cases), external fixator group (18 cases) and plate screw internal fixation group (16 cases).The radial height, palm inclination angle, ulnar inclination angle and Gartland-Werley (G-W) score after treatment were compared among various groups.Results Fifty-eight cases were followed up.The radial height, ulnar inclination angle and G-W score had statistical difference among 3 groups (P<0.05), while the palm inclination angle had no statistical difference among 3 groups (P>0.05);the difference of radial height and ulnar inclination angle between the external fixator group and plate screw internal fixation group had no statistical significance (P>0.05), but there were statistically significant differences when these two groups were compared with the manual reduction and splint external fixation group respectively (P<0.05).The G-W score had no statistical difference between the manual reduction splint fixation group and the external fixator group (P>0.05) , but there were statistically significant differences when these two groups were compared with the the plate screw internal fixation group respectively (P<0.05).Conclusion The radial height restoration may better recovery ulnar inclination angle and improve the joint function.
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