摘要
目的建立复合功能评价体系研究单钢板与双钢板内固定治疗老年C3型桡骨远端骨折的临床疗效。方法回顾性选取2018年9月至2021年8月安徽理工大学第一附属医院收治的62例老年(≥60岁)C3型桡骨远端骨折患者,按照手术方法分为双侧钢板内固定治疗组(双板组)和单侧钢板内固定治疗组(单板组);记录两组患者术前解剖角度、腕关节活动度(屈伸)及桡骨短缩情况,随访术后第3、6、9个月及12个月的解剖角度、腕关节活动度(屈伸)、临床Gartland-Werley、DASH、Cooney腕关节评分和临床愈合时间,建立复合评价表综合评价两组术后恢复情况。结果两组患者术前桡骨各解剖指标差异无统计学意义(均P>0.05)。术后各解剖角度及腕关节活动范围均属于正常范围,术后3、6个月内两组桡骨各解剖指标差异无统计学意义(均P>0.05),但双板组术后9、12个月掌倾角、尺偏角、腕关节掌屈和背伸活动度较稳定,均优于单板组(均P<0.05),随时间增加单板组掌倾角和尺偏角呈上升趋势。术后两组桡骨短缩情况明显恢复,且双板组9、12个月较单板组桡骨长度维持更好(均P<0.05)。两组的术后3、6个月内各评分差异无统计学意义(均P>0.05),但双板组术后9、12个月Gartland-Werley评分、DASH评分和Cooney腕关节评分明显优于单板组,差异有统计学意义(均P<0.05)。单板组治疗临床愈合时间为(14.51±0.88)周,最长为108 d,而双板组治疗临床愈合时间为(12.03±1.77)周,最长为129 d,差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。两组最终复合评价结果差异无统计学意义(P>0.05),但双板治疗组总分值小于单板组,差值为39.67分,说明在各项评分中双板组仍有一定优势。结论经复合评估体系评估,单钢板与双钢板治疗老年C3型桡骨远端骨折均可获得满意疗效,双钢板固定桡骨远端骨折在维持关节稳定性和提升关节活动度上仍有一定意义。
Objective To establish a composite functional evaluation system to study the clinical efficacy of single plate and double plate internal fixation in the treatment of C3 distal radius fractures in the elderly.Methods 62 elderly patients(≥60 years old)with type C3 distal radius fractures who were admitted to the First Affiliated Hospital of Anhui University of Science and Technology from September 2018 to August 2021 were retrospectively selected and divided into two groups according to the surgical methods:bilateral plate internal fixation treatment group(double plate group)and unilateral plate internal fixation treatment group(single plate group);The preoperative anatomical angle,wrist mobility(flexion and extension)and radius shortening of the two groups were recorded.The anatomical angle,wrist mobility(flexion and extension),clinical Gartland-Werley,DASH Score for Upper Limb Function(DASH),Wrist Joint Cooney Score and clinical healing time at the 3rd,6th,9th and 12th months after operation were followed up.A composite evaluation table was established to comprehensively evaluate the postoperative recovery of patients in the two group.Results There was no significant difference in anatomical indexes of radius between the two groups before operation(all P>0.05).All anatomical angles and wrist range of motion were within the normal range after operation,and there was no statistical difference between the two groups in each anatomical index of radius within 3 and 6 months after operation(all P>0.05).However,the palmar inclination,ulnar deviation,wrist flexion and dorsiflexion mobility of the double plate group were relatively stable at 9 and 12 months after operation,which were better than those of the single plate group(all P<0.05).The palmar inclination and ulnar deviation of the single plate group increased with time.After operation,the radius shortening of the two groups recovered significantly,and the radius length of the double plate group was maintained better than those of the single plate group for 9 and 12 months(all P<0.05).There was no significant difference in the scores of the two groups within 3 and 6 months after operation(all P>0.05),but the Gartland Werley score,DASH score and Cooney wrist score of the double plate group were significantly better than those of the single plate group at 9 and 12 months after operation(all P<0.05).The clinical healing time of single plate treatment was(14.51±0.88)weeks,the longest was 108 days,while that of double plate treatment was(12.03±1.77)weeks,the longest was 129 days,with statistically significant difference(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).There was no statistically significant difference between the two groups in the final composite evaluation results(P>0.05),but the total score of the double plate group was smaller than that of the single plate group,with a difference of 39.67 points,indicating that the double plate group still had certain advantages in various scores.Conclusions According to the composite evaluation system,both single plate and double plate treatment of C3 distal radius fractures in the elderly can achieve satisfactory results.Double plate fixation of distal radius fractures still has a certain significance in maintaining joint stability and improving joint mobility.
作者
陈廷
徐高伟
王传兵
许克庆
姚鹏飞
Chen Ting;Xu Gaowei;Wang Chuanbing;Xu Keqing;Yao Pengfei(Department of Orthopedics,the First Affiliated Hospital of Anhui University of Science and Technology,Huainan 232007,China)
出处
《中国医师杂志》
CAS
2022年第10期1546-1551,共6页
Journal of Chinese Physician
关键词
桡骨骨折
老年人
骨板
骨折固定术
Radius fractures
Aged
Bone plates
Fracture fixation
作者简介
通信作者:徐高伟,Email:wwwww004@126.com
