蔡效信

（淄博市第一医院，山东淄博255200）

手术与非手术治疗桡骨远端骨折对患者腕关节功能恢复的影响

蔡效信

（淄博市第一医院，山东淄博255200）

目的探讨采用手术切开复位与手法复位石膏外固定的非手术疗法对桡骨远端骨折患者腕关节功能恢复的影响。方法选取本院骨科收治的97例桡骨远端骨折患者进行回顾性分析，其中采取切开复位内固定手术治疗53例（手术组）、采取手法复位石膏外固定治疗44例（非手术组），对比两组患者的腕关节功能恢复情况。结果手术组的骨折愈合时间平均为（5.8± 1.1）周，非手术组为（6.0±0.8）周，两组患者的骨折愈合时间差异无统计学意义（P＞0.05）。术后3个月，手术组和非手术组患者的腕关节背伸、腕关节曲度、尺偏角、桡偏角、尺骨移位测定值差异无统计学意义（P＞0.05），手术组的掌倾角、握力、桡骨高度测定值优于非手术组（P＜0.05）；术后6个月，两组患者腕关节背伸、腕关节曲度、尺偏角、桡偏角、掌倾角、握力、桡骨高度、尺骨移位测定值差异均无统计学意义（P＞0.05）；术后6个月，手术组的腕关节功能优良率96.2%与非手术组患者的90.9%差异无统计学意义（P＞0.05）。结论对于OTA分级相当的患者，采用手术切开复位内固定有利于患者腕关节功能的早期恢复，但是远期恢复效果手术与非手术治疗差异并不显著。

桡骨远端骨折；手术切开复位；手法复位；石膏外固定；腕关节

〔Abstract〕Objective To investigate the effect of open reduction and manipulative reduction with plaster external fixation on wrist function recovery in patients with distal radius fractures.M ethods The 97 cases of distal radial fractures patients selected from department of orthopedics in our hospital were retrospectively analyzed，53 cases of patients（surgery group）were taken open reduction internal fixation surgery，44 cases of patients（non-surgery group）were taken manual reduction with plaster external fixation.The wrist function recovery of the two groups was compared.Results The fracture healing time of the operation group was for（5.8±1.1）weeks，the non operative group was for（6.0±0.8）weeks，the fracture healing time of the two groups was not statistically significant（P＞0.05）.After 3 months of operation，the wrist dorsiflexion，the curvature of the wrist，ulnar deviation，radial angle，ulnar shift in the surgery group and non-surgical group were not statistically significant（P＞0.05）.The palmar angle，grip strength，radial height of opration group were better than nonsurgical group（P＜0.05）.After six months of treatment，the wrist dorsiflexion，the curvature of the wrist，ulnar deviation，radial angle，volar tilt，grip strength，radial height，ulnar shift of the two groups were not significantly significant（P＞0.05）.After 6 months of treatment，the good rate of wrist joint 96.23%of surgery group and 90.91%in non-surgery group were not statistically significant（P＞0.05）.Conclusion The open reduction for patients with quite OTA classification is good for an early recovery of wrist function，but the long-term restoration in surgical and non-surgical treatment was not significant.

〔Keywords〕distal radius fracture；open reduction；manipulative reduction；plaster external fixation；wrist joint

桡骨远端骨折是临床常见的骨折类型，可发生于任何年龄段，中老年人由于大多伴有骨质疏松，因而是桡骨远端骨折的高发人群。……