X线分型对老年人Colles骨折治疗策略及预后的价值研究

发布时间：2018-01-06 13:16

本文关键词：X线分型对老年人Colles骨折治疗策略及预后的价值研究　出处：《临床放射学杂志》2016年10期 　论文类型：期刊论文

【摘要】：目的探讨X线分型在老年人Colles骨折治疗策略选择及预后评估中的价值。方法对44例60岁以上Colles骨折患者进行纵向回顾性研究。根据Frykman分型将病例分为关节内型骨折组(26例)和关节外型骨折组(18例)。关节内型骨折组接受保守治疗11例,手术治疗15例;关节外型骨折组接受保守治疗10例,手术治疗8例。所有患者在受伤后治疗前、治疗后1周、2周、6~8周均行腕关节X线平片检查。测量所有患者复位前后X线平片的桡骨掌倾角、桡骨尺偏角、桡骨短缩值。骨折愈合的影像学结果应用Lidstrom分级进行评价。统计并比较两组患者保守治疗、手术治疗结果。结果按照Lidstrom分级,44例Colles骨折患者经治疗后75.0%的影像学结果可接受。其中关节内型骨折组与关节外型骨折组可接受率分别为76.9%、72.2%,两组比较差异无统计学意义(P=0.723)。关节内型骨折组保守治疗与手术治疗的可接受率分别为54.5%和93.3%,两种治疗方式差异有统计学意义(P0.05);关节外型骨折组保守治疗与手术治疗的可接受率分别为60.0%和87.5%,两种治疗方式差异无统计学意义(P0.05)。结论老年人Colles骨折患者,关节内型手术治疗效果优于保守治疗,关节外型保守治疗与手术治疗效果相仿。
[Abstract]:Objective to investigate the X-ray type fracture treatment evaluation strategies and prognosis in elderly Colles patients. Methods 44 patients above 60 years old Colles fracture of longitudinal review patients. According to the Frykman classification, the cases were divided into intra-articular fracture group (26 cases) and the joint appearance of fracture group (18 cases) joint. In the fracture group received conservative treatment in 11 cases, 15 cases of surgical treatment; joint appearance fracture group received conservative treatment in 10 cases, 8 cases of surgical treatment. All patients after injury before 1 weeks, after 2 weeks of treatment, 6~8 Zhou Junhang wrist X-ray measurement. All the patients before and after treatment of X-ray the radial palmar tilt, radial ulnar deviation, radial shortening value. To evaluate the fracture healing of the imaging results using Lidstrom classification. Statistics and compared two groups of patients with conservative treatment, surgical treatment results. Results according to Lidstrom classification, 44 cases of Colles fracture patients after treatment 7 5% the imaging results are acceptable. The intra articular fracture group and fracture group joint appearance acceptable rates were 76.9%, 72.2%, two groups had no statistically significant difference (P=0.723). Intra articular fracture group of conservative treatment and surgical treatment acceptable rates were 54.5% and 93.3%, there were significant differences between the two the treatments (P0.05); joint fracture group with conservative treatment and surgical treatment acceptable rates were 60% and 87.5%, there was no difference among the two treatments (P0.05). Conclusion the elderly patients with Colles fracture, intra-articular surgery is better than conservative treatment, the treatment effect of conservative treatment and surgical joint appearance similar.

【作者单位】：浙江大学医学院附属第二医院放射科;宁波市第六医院放射科;浙江省人民医院放射科;宁波市第六医院手外科;
【分类号】：R687.3;R816.8
【正文快照】： 伸展型桡骨远端骨折(Colles骨折)是桡骨最常见的骨折类型,其发生率随年龄的增长而增长,60岁以上中老年人因为骨质疏松,发病率明显增高[1~4]。老年人Colles骨折临床上主要采取石膏外固定闭合复位保守治疗,或者经皮克氏针固定手术复位。前者可使绝大多数病例获得较满意的复位,但

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