老年性Colles骨折的保守治疗与掌侧锁定钢板治疗的临床疗效对比
Comparison of clinical efficacy between conservative treatment and volar locking plate treatment of senile Colles fractures
姚君伟 1龙浩 1冯斌 1张磊 1张轶 1姚爱明1
作者信息
- 1. 徐州医科大学附属医院急救中心(江苏徐州,221000)
- 折叠
摘要
目的:探讨Colles骨折的保守治疗与掌侧锁定钢板治疗在老年人患者中的临床疗效对比.方法:回顾性纳入徐州医科大学附属医院2021年3月-2023年3月期间接受治疗的桡骨远端骨折合并有移位的老年患者共64例,将患者按治疗方式分为两组:手法复位石膏夹板外固定治疗组(非手术组,32例)和掌侧锁定版切开内固定治疗组(手术组,32例).比较两组患者的术中指标,术前及术后3、6个月时的腕关节功能Cooper评分、角度测定、握力、DASH评分变化及并发症发生情况.结果:两组患者术中指标,术前及术后3个月的腕关节Coop-er评分、握力、DASH评分比较,差异均有统计学意义(P＜0.05);且上述腕关节指标改善程度手术组均优于非手术组,差异均有统计学意义(P＜0.05);术后6个月时,两组腕关节功能指标、握力、DASH评分改善程度差异无统计学意义,而两组患者放射线指标测量术前术后差异有统计学意义(P＜0.05),两组患者术后3个月、6个月放射线指标测量差异无统计学意义.结论:手术治疗老年桡骨远端骨折,实现直观可视下骨折端解剖复位和固定,手术治疗有可能对早期3个月内腕关节功能恢复有明显效果,随着术后康复时间延长,到术后6个月时,两组患者腕关节Cooper评分、握力、DASH评分无明显差异.
Abstract
Objective:To investigate the clinical efficacy of conservative treatment and palmar locking plate treatment in Colles fracture of elderly patients.Methods:Retrospective analysis was performed on elderly patients with displaced Colles fracture between 50 and 75 years old who were treated in Affiliated Hospital of Xuzhou Med-ical University from March 2021 to March 2023.According to the treatment,they were divided into plaster splint external fixation(n=32)and palmar lock version incision internal fixation(n=32).Intraoperative indexes,Cooper score,Angle measurement,grip strength,DASH score and complications were compared between the two groups before surgery and 3 and 6 months after surgery.Results:There were statistically significant differences between the two groups in Cooper score,grip strength and DASH score before and 3 months after operation(P＜0.05).In addition,the improvement degree of the wrist joint indexes in the surgery group was better than that in the non-surgery group,and the differences were statistically significant(P＜0.05).There was no statistical significance in the improvement of wrist joint function index,grip strength and DASH score between the two groups 6 months after surgery,while there was statistical significance in the measurement of radiological index between the two groups before and after surgery(P＜0.05),and there was no statistical significance in the measurement of radio-logical index between the two groups at 3 months and 6 months after surgery.Conclusion:Surgical treatment of distal radius fractures in elderly patients can achieve visual anatomic reduction and fixation of the lower fracture end,and the diagnosis and treatment may have a significant effect on the functional recovery of the wrist at the early 3 months after surgery.With the extension of postoperative rehabilitation time,there was no significant difference in the wrist Cooper score,grip strength and DASH score between the two groups at 6 months af-ter surgery.
关键词
老年性/桡骨远端骨折/掌侧锁定钢板/腕关节功能Key words
old age/distal radius fracture/palmar locking plate/wrist function引用本文复制引用
出版年
2024
NETL
NSTL
万方数据