中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2012年
3期
249-253
,共5页
董强%马信龙%马宝通%吴磊
董彊%馬信龍%馬寶通%吳磊
동강%마신룡%마보통%오뢰
桡骨骨折%骨折固定术,内%外固定器
橈骨骨摺%骨摺固定術,內%外固定器
뇨골골절%골절고정술,내%외고정기
Radial fractures%Fracture fixation,internal%External fixators
目的 比较LCP钢板与外固定架治疗C型桡骨远端骨折的疗效.方法 回顾性分析2007年10月至2010年10月分别采用LCP钢板和外固定架治疗C型桡骨远端骨折的病例.其中LCP组38例,男13例,女25例；年龄23～65岁,平均45.1岁；按AO/OTA分型:C1型15例,C2型18例,C3型5例.外固定组26例,男12例,女14例；年龄25～60岁,平均47.1岁；按AO/OTA分型:C1型11例,C2型13例,C3型2例.比较两组术后影像学指标、功能指标,并采用Gartland-Werley功能评分标准对术后疗效进行评估.结果 所有患者均获得随访,随访时间LCP组12～36个月,平均23.8个月；外固定组12～44个月,平均31.2个月.X线片均显示两组骨折全部愈合.两组患者尺偏角、桡骨高度、腕关节背伸、掌屈、尺偏、桡偏、旋前、旋后及Gartland-Werley评分均无显著性差异.LCP组掌倾角11.71°±3.02°,外固定组掌倾角7.15°±2.98°,LCP组优于外固定组.LCP组伤口感染2例,正中神经损伤1例,固定松动1例；外固定组钉道感染3例,固定松动1例,腕关节僵硬2例.结论 两种固定方式治疗C型桡骨远端骨折均可达到较为满意的临床效果,LCP钢板术后影像学结果稍好,固定可靠.临床可根据患者具体情况选择治疗方式.
目的 比較LCP鋼闆與外固定架治療C型橈骨遠耑骨摺的療效.方法 迴顧性分析2007年10月至2010年10月分彆採用LCP鋼闆和外固定架治療C型橈骨遠耑骨摺的病例.其中LCP組38例,男13例,女25例；年齡23～65歲,平均45.1歲；按AO/OTA分型:C1型15例,C2型18例,C3型5例.外固定組26例,男12例,女14例；年齡25～60歲,平均47.1歲；按AO/OTA分型:C1型11例,C2型13例,C3型2例.比較兩組術後影像學指標、功能指標,併採用Gartland-Werley功能評分標準對術後療效進行評估.結果 所有患者均穫得隨訪,隨訪時間LCP組12～36箇月,平均23.8箇月；外固定組12～44箇月,平均31.2箇月.X線片均顯示兩組骨摺全部愈閤.兩組患者呎偏角、橈骨高度、腕關節揹伸、掌屈、呎偏、橈偏、鏇前、鏇後及Gartland-Werley評分均無顯著性差異.LCP組掌傾角11.71°±3.02°,外固定組掌傾角7.15°±2.98°,LCP組優于外固定組.LCP組傷口感染2例,正中神經損傷1例,固定鬆動1例；外固定組釘道感染3例,固定鬆動1例,腕關節僵硬2例.結論 兩種固定方式治療C型橈骨遠耑骨摺均可達到較為滿意的臨床效果,LCP鋼闆術後影像學結果稍好,固定可靠.臨床可根據患者具體情況選擇治療方式.
목적 비교LCP강판여외고정가치료C형뇨골원단골절적료효.방법 회고성분석2007년10월지2010년10월분별채용LCP강판화외고정가치료C형뇨골원단골절적병례.기중LCP조38례,남13례,녀25례；년령23～65세,평균45.1세；안AO/OTA분형:C1형15례,C2형18례,C3형5례.외고정조26례,남12례,녀14례；년령25～60세,평균47.1세；안AO/OTA분형:C1형11례,C2형13례,C3형2례.비교량조술후영상학지표、공능지표,병채용Gartland-Werley공능평분표준대술후료효진행평고.결과 소유환자균획득수방,수방시간LCP조12～36개월,평균23.8개월；외고정조12～44개월,평균31.2개월.X선편균현시량조골절전부유합.량조환자척편각、뇨골고도、완관절배신、장굴、척편、뇨편、선전、선후급Gartland-Werley평분균무현저성차이.LCP조장경각11.71°±3.02°,외고정조장경각7.15°±2.98°,LCP조우우외고정조.LCP조상구감염2례,정중신경손상1례,고정송동1례；외고정조정도감염3례,고정송동1례,완관절강경2례.결론 량충고정방식치료C형뇨골원단골절균가체도교위만의적림상효과,LCP강판술후영상학결과초호,고정가고.림상가근거환자구체정황선택치료방식.
Objective To compare the clinical effects of the volar locking compression plate (LCP) and external fixator in the treatment of the AO type-C distal radial fractures.Methods From October 2007 to October 2010,64 cases of AO type-C distal radial fractures which had been treated with volar LCP and external fixator were retrospectively analyzed respectively.LCP group consisted of 38 patients,including 13 males and 25 females with an average age of 45.1 years.According to AO/OTA classification,there were 15 type-C1,18 type-C2,and 5 type-C3.External fixator group consisted of 26 patients,including 12 males and 14 females with an average age of 47.1 years.There were 11 type-C1,13 type-C2,and 2 type-C3.Outcomes were assessed by radiographic parameters,function parameters,and Gartland-Werley functional score.Results All the patients were followed up.X-rays showed all fractures healed.LCP group was followed up for an average of 23.8 months.External fixator group was followed up for an average of 31.2 months.According to the Gartland-Werley score,the excellent and good rate was 81.6％ in the LCP group and 76.9％ in the external fixator group,with a Gartland-Werley score of 4.50±3.55 and 5.04±3.74 respectively.There were no significant differences in wrist flexion,extension,ulnar deviation,radial deviation,pronation,supination,the parameter of ulnar inclination and radial height and the Gartland-Werley score.The volar tilt was better in the LCP group than in the external fixator group.There were 2 cases of wound infection,1 case of median nerve injury,1 case of plate loosening in LCP group; 3 cases of pin tract infection,1 case of fixator loosening,and 2 cases of wrist stiffness in the external fixator group.Conclusion LCP group had better imaging outcomes with a reliable fixation,but both of the groups can achieve satisfactory clinical results.The choices of treatment method depend on the patient's clinical conditions.
