两种手术方案治疗不稳定型桡骨远端骨折的临床研究

发布时间：2018-01-21 12:34

  本文关键词： 不稳定桡骨远端骨折 T型锁定加压钢板 外固定架 疗效分析　出处：《新疆医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：评估切开复位T型锁定加压钢板内固定和有限切开外固定支架联合克氏针内固定两种手术方案治疗不稳定型桡骨远端骨折的临床疗效,探讨不稳定桡骨远端骨折治疗方案的选择。方法：以2012年9月至2014年9月新疆医科大学第五附属医院骨科收入院采用手术治疗的不稳定桡骨远端骨折患者为研究对象,根据诊断标准、纳入标准及排除标准选取符合要求的患者共51例(51侧)。其中男性24例,女性27例,平均年龄56岁。左侧20例,右侧31例。根据AO分型, B型28侧,C型23侧。切开复位内固定组26例,有限切开外固定架联合克氏针内固定组25例。记录手术时间,术后3个月、6个月随访时测量腕关节活动度(背伸、掌屈、尺偏、桡偏)及相关影像学资料(掌倾角、尺偏角、桡骨缩短、关节面恢复情况),依据Gartland-Werley功能评分对患者腕关节功能进行评价,对两组资料进行分析研究。结果：ORIF组平均手术时间约76分钟,IFEF组约55分钟。术后51例患者全部得到随访,经过6-12个月的临床随访观察所有患者均达到了骨性愈合。ORIF组有切口感染1例；IFEF组有钉道感染5例。在随访期间对比ORIF组腕关节活动度及相关影像学数据与IFEF组无明显差异。根据Gartland-Werley功能评价表进行评价,ORIF组：优14例,良10例,可2例,优良率92.31%；IFEF组：优8例,良15例,可2例,优良率92%,两组患者均获得满意的腕关节功能恢复,两组优良率无明显差异。结论：切开复位T型锁定加压钢板内固定和有限切开外固定架联合克氏针内固定两种手术方案治疗不稳定型桡骨远端骨折,腕关节功能恢复无差异。
[Abstract]:Objective: to evaluate the clinical effect of open reduction with T-locking compression plate internal fixation and limited open external fixation with Kirschner needle fixation in the treatment of unstable distal radius fractures. To explore the treatment of unstable distal radius fracture. Patients with unstable distal radius fractures treated surgically in Department of Orthopaedics, 5th affiliated Hospital of Xinjiang Medical University from September 2012 to September 2014 were studied. According to the diagnostic criteria, 51 patients were selected according to the criteria of inclusion and exclusion, including 24 males and 27 females, with an average age of 56 years and 20 patients on the left side. According to AO classification, there were 28 cases of type B and 23 sides of type C, 26 cases of open reduction and internal fixation group and 25 cases of limited open external fixation frame combined with Kirschner needle fixation group. The operation time was recorded. The wrist motion (dorsal extension, palmar flexion, ulnar deviation, radial deviation) and related imaging data (metacarpal inclination, ulnar angle, radius shortening, articular surface recovery) were measured 3 months and 6 months after operation. The wrist function was evaluated according to the Gartland-Werley score and the data of the two groups were analyzed. Results the average operation time of the two groups was about 76 minutes. IFEF group was about 55 minutes. All the 51 patients were followed up after 6 to 12 months of clinical follow-up. All the patients achieved bone healing. 1 case in the ORIF group had incision infection. There were 5 cases of nail infection in IFEF group. There was no significant difference in wrist motion and related imaging data between ORIF group and IFEF group during the follow-up period. According to Gartland-Werley function, there was no significant difference between the two groups. The evaluation forms are evaluated. ORIF group: excellent 14 cases, good 10 cases, fair 2 cases, excellent and good rate 92.31; IFEF group: excellent in 8 cases, good in 15 cases, fair in 2 cases, excellent and good rate was 92%. Conclusion: open reduction with T-type locking compression plate and limited open and external fixation with Kirschner's needle for the treatment of unstable distal radius fractures. There was no difference in wrist function recovery.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
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本文编号：1451492