[1]张辉 袁治国△ 邵建军 王冠 朱涛 白登彦.两种固定方法治疗老年不稳定性桡骨远端Colles骨折的疗效分析与评价[J].中国中医骨伤科杂志,2016,24(10):20-23.
 ZHANG Hui YUAN Zhiguo SHAO Jianjun WANG Guan ZHU Tao BAI Dengyan.Analysis and Evaluation on the Efficacy of Two Different Methods for the Treatment of Instability Colles Fracture of the Distal Radius in Elderly[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2016,24(10):20-23.
点击复制

两种固定方法治疗老年不稳定性桡骨远端Colles骨折的疗效分析与评价
分享到:

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第24卷
期数:
2016年10期
页码:
20-23
栏目:
临床研究
出版日期:
2016-10-01

文章信息/Info

Title:
Analysis and Evaluation on the Efficacy of Two Different Methods for the Treatment of Instability Colles Fracture of the Distal Radius in Elderly
文章编号:
1005-0205(2016)10-0020-04
作者:
张辉1 袁治国1△ 邵建军1 王冠1 朱涛1 白登彦1
1.甘肃省第二人民医院(兰州,730000)
△.通信作者 E-mail:zhanghuicalvin2007@126.com
Author(s):
ZHANG Hui1 YUAN Zhiguo1△ SHAO Jianjun1 WANG Guan1 ZHU Tao1 BAI Dengyan1
1.Department of Orthopedics, Second People's Hospital of Gansu Province, Lanzhou 730000, China.
关键词:
老年不稳定性 桡骨远端Colles骨折 手术治疗 临床研究
Keywords:
elderly instability distal radius fracture surgical treatment clinical trial
分类号:
R683.41
文献标志码:
A
摘要:
目的:评价70岁以上不稳定性桡骨远端Colles骨折患者闭合复位管形石膏固定与切开复位掌侧锁定钢板固定的临床疗效。方法:回顾性分析2008 年8月至2014 年7月收治的124例70岁以上不稳定性桡骨远端Colles骨折患者,分别采用中医手法整复管形石膏固定与切开复位掌侧锁定钢板固定两种方法治疗,对其进行客观评估、主观功能效果评价和放射学评价。结果:所有患者均获得6~18个月随访,Colles骨折病人经开放复位掌侧锁定钢板内固定后的放射学结果(掌倾、尺偏和桡骨短缩)明显有差异于管形石膏固定组(P< 0.05),两组间PRWE,DASH和Green-O'Brien评分等临床效果没有明显差异,管形石膏组病人的疼痛程度明显低于切开复位内固定组。结论:大于70岁的老年病人不论手术与否,其主观和功能效果没有明显差异,老年病人放射学结果不满意不影响功能效果,该类病人可选用非手术处理。
Abstract:
Objective:To evaluate the clinical effect between closed reduction while tubular plaster fixation and open reduction while volar locking plate fixation for the treatment of instability Colles fracture in patients over 70 years old. Methods:All 124 cases with instability Colles fracture over 70 years old were retrospective analysis from August 2008 to July 2014. They were treated with closed reduction while tubular plaster fixation and open reduction while volar locking plate fixation. The objective evaluation, subjective function effect, and radiological evaluation were evaluated. Results:They were all followed-up for 6 to 18 months. The radiology results of internal fixation group was superior to the plaster fixation group(P<0.05). But the degree of pain in the plaster fixation group was obviously lower than the internal fixation group(P<0.05). The active range, PRWE, DASH, and Green-O'Brien score were not significantly different between the two groups(P>0.05). Conclusion:The subjective and functional results are not significantly different whether surgery or not in patients over 70 years old. The unsatisfied radiology results are not affecting their function, so these patients can choose non-surgical treatment.

参考文献/References:

[1] 刘攀,卢冰,王跃,等.闭合复位与切开复位治疗老年桡骨远端骨折的疗效及对腕关节功能的影响[J].中国老年学杂志,2016,36(4):915-916.
[2] 俞军卫,吴成如,廖国权,等.老年桡骨远端骨折手术与非手术治疗的临床对照评价[J].安徽医学,2016,37(1):71-73.
[3] 颜勇卿.手术治疗的桡骨远端骨折预后指标间相关性分析[J].中国骨与关节损伤杂志,2014,29(3):251-252.
[4] 郭世明,石玲玲,郭志民,等.手法复位石膏外固定和切开复位钢板内固定治疗骨质疏松性桡骨远端骨折的比较研究[J].中医正骨,2015,27(4):15-20.
[5] GRADL G,GRADL G,WENDT M,et al.Non-bridging external fixation employing multiplanar K-wires versus volar locked plating for dorsally displaced fractures of the distal radius[J].Arch Orthop Trauma Surg,2013,133(5):595-602.
[6] Goldfarb CA,Rudzki JR,Catalano LW,et al.Fifteen-year outcome of displaced intraarticular fractures of the distal radius[J].J Hand Surg Am,2006,31(4):633-639.
[7] Karantana A,Downing ND,Forward DP,et al.Surgical treatment of distal radial fractures with a volar locking plate versus conventional percutaneous methods[J].Bone Joint Surg,2013,95(19):1737-1744.
[8] 金建强,张骏,陆逸庭,等.解剖型桡骨远端掌侧锁定接骨板治疗老年桡骨远端骨折[J].中医正骨,2013,25(12):66-68.
[9] 朱勇,陈彦,蔡立峰.手法整复小夹板固定治疗桡骨远端骨折[J].中国中医骨伤科杂志,2015,23(8):58-60.
[10] 林砚铭,黄勇,尉伟卫.手法整复小夹板固定治疗老年C型桡骨远端骨折36例[J].中国中医骨伤科杂志,2015,23(5):43-45.
[11] 刘文源,赵清臣,徐实现.掌侧锁定加压钢板结合克氏针固定治疗桡骨远端 C 型骨折[J].中医正骨,2012,24(8):64-65.
[12] Kandemir U,Matityahu A,Desai R,et al.Does a volar locking plate provide equivalent stability as a dorsal nonlocking plate in a dorsally comminuted distal radius fracture:a biomechanical study[J].J Orthop Trauma,2008,22(5):605-610.
[13] Swigart CR,Badon MA,Bruegel VL,et al.Assessment of pronator quadratus repair integrity following volar plate fixation for distal radius fractures:a prospective clinical cohort study[J].J Hand Surg Am,2012,37(9):1868-1873.
[14] Hershman SH,Immerman I,Bechtel C,et al.The effects of pronator quadratus repair on outcomes after volar plating of distal radius fractures[J].J Orthop Trauma,2013,27(3):130-133.
[15] Lutz K,Yeoh KM,Macder mid JC,et al.Complications associated with operative versus nonsurgical treatment of disal radius fractures in patients aged 65 years and older[J].J Hand Surg,2014,39(7):1280-1286.
[16] Wilcke MKT,Hammar Berg H,Adolphson PY.Epidemiology and changed surgical treatment methods for fractures of the distal radius:a registry analysis of 42 583 patients in Stockholm County Sweden 2004-2010[J].Acta Orthopaedica,2013,84(3):292-296.
[17] 惠正广,张镇,李朝顶,等.3 种方法治疗桡骨远端骨折的疗效比较[J].中国骨与关节损伤杂志,2015,30(5):494-496.

更新日期/Last Update: 2016-10-15