锁定加压钢板联合外固定架与单纯锁定加压钢板治疗C型桡骨远端骨折的疗效比较

摘要

Objective To compare the outcomes of type C distal radius fractures treated with locking compression plate (LCP) combined with external fixator and single LCP. Methods The 60 patients with type C distal radius fractures who underwent surgery, according to different operation methods, were divided into LCP internal fixation combined with external fixator group (Combined group, 30 patients) and single LCP internal fixation group (LCP group,30 patients). The clinical results were assessed and compared base on operation-related situations,radiologi-cal assessments,range of wrist activity,VAS,Gartland-Werley wrist score. Results The operation duration of com-bined group was longer than the time of LCP group, but no significant difference was found between the two groups (P>0.05). All patients were followed up for 24~36 months. The recoveries of the radial tilt angle,radial inclina-tion angle and radial height of the combined group were better than the ones of LCP group at 3 d,6 weeks and 24 months after operation,and the differences were statistically significant (P<0.05). No significant differences were found in ranges of wrist palmar flexion and dorsiflexion between the two groups at 24 months after operation (P>0.05). The VAS,Gartland-Werley wrist score of Combined group were all better than the ones of LCP group,but no significant differences were found between the two groups(P>0.05). Conclusions Two kinds of methods can ob-tain similar satisfactory clinical outcome in treating type C distal radius fractures. But the radiological assessments in-cluding radial tilt angle,radial inclination angle and radial height of operation with LCP combined with external fixator are better than the ones of operation with simple LCP.%目的 比较锁定加压钢板联合外固定架和单纯锁定加压钢板治疗C型桡骨远端骨折的疗效.方法手术治疗60例C型桡骨远端骨折患者,按治疗方法分为锁定加压钢板联合外固定架组(联合组,30例)和单纯锁定加压钢板组(LCP组,30例).比较两组手术相关指标、影像学指标及腕关节活动度、疼痛VAS评分、Gartland-Werley评分.结果 联合组手术时间较LCP组长,但差异无统计学意义(P>0.05).患者均获得随访,时间24~36个月.术后3 d、6周、24个月随访时,联合组掌倾角、尺偏角、桡骨高度的改善优于LCP组,差异均有统计学意义(P<0.05).术后24个月两组腕关节掌屈、背伸活动度比较差异均无统计学意义(P>0.05).联合组VAS评分及Gartland-Werley评分稍优于LCP组,但差异均无统计学意义(P>0.05).结论锁定加压钢板联合外固定架与单纯锁定加压钢板治疗C型桡骨远端骨折效果均良好,但在掌倾角、尺偏角、桡骨高度恢复方面前者优于后者.