许杨

【摘要】 目的 对比分析保守治疗与手术治疗老年桡骨远端骨折的临床治疗效果及安全性。方法 老年桡骨远端骨折患者68例， 随机分成对照组及观察组， 每组34例。对照组使用手法复位的保守治疗， 观察组患者使用切开复位内固定的手术治疗， 治疗后随访12个月， 比较两组患者骨折愈合时及术后12个月

Cooney评分、骨折愈合后桡骨掌倾角、尺偏角、桡骨缩短以及术后并发症的发生情况。结果 观察组患者骨折愈合时Cooney评分为（86.2±5.9）分， 高于对照组的（68.7±5.2）分（t=12.975， P<0.05）；观察组患者术后12个月Cooney评分为（94.9±5.2）分， 与对照组的（94.5±5.0）分比较， 差异无统计学意义（t=0.323， P>0.05）。观察组患者骨折愈合后桡骨掌倾角（9.7±2.2）°， 高于对照组的（5.8±2.4）°， 差异具有统计学意义（t=6.985， P<0.05）；觀察组患者骨折愈合后桡骨尺偏角（20.5±2.8）°， 高于对照组的（16.3±2.1）°（t=6.997， P<0.05）；观察组患者骨折愈合后桡骨缩短为（1.8±1.3）°， 对照组患者骨折愈合后桡骨缩短为（3.2±1.5）°， 两组比较差异具有统计学意义（t=-4.113， P<0.05）；观察组患者术后总并发症发生率为26.5%， 对照组患者术后总并发症发生率为23.5%， 两组比较差异无统计学意义（χ2=0.078， P>0.05）。结论 老年桡骨远端骨折使用手术治疗能够得到更优秀的功能复位及早期复位， 但是保守治疗与手术治疗均可以达到骨折远期功能恢复的效果， 安全性确切。

【关键词】 保守治疗；手术治疗；桡骨远端骨折；老年人

DOI：10.14163/j.cnki.11-5547/r.2017.05.021

Comparative analysis of effects by conservative treatment and surgical treatment in the treatment of senile distal radius fracture XU Yang. Department of Orthopedics， Shenyang City Tiexi District Huakang Hospital， Shenyang 110026， China

【Abstract】 Objective To comparatively analyze clinical effects and safety by conservative treatment and surgical treatment in the treatment of senile distal radius fracture. Methods A total of 68 senile distal radius fracture patients were randomly divided into control group and observation group， with 34 cases in each group. The control group received conservative treatment by manual reduction， and the observation group received surgical treatment by open reduction and internal fixation. Follow-up lasted for 12 months after treatment. Comparison was made on Cooney score after fracture healing and in postoperative 12 months， radial palmar inclination， ulnar inclination， radial shortening and postoperative complications between the two groups. Results The observation group had higher Cooney score after fracture healing as （86.2±5.9） points than （68.7±5.2） points in the control group （t=12.975， P<0.05）. The observation group had Cooney score in postoperative 12 months as （94.9±5.2） points，

which was （94.5±5.0） points in the control group， and their difference had no statistical significance （t=0.323， P>0.05）. The observation group had higher radial palmar inclination after fracture healing as （9.7±2.2）° than （5.8±2.4）° in the control group， and the difference had statistical significance （t=6.985， P<0.05）. The observation group had higher ulnar inclination after fracture healing as （20.5±2.8）° than （16.3±2.1）° in the control group （t=6.997， P<0.05）. The observation group had radial shortening after fracture healing as （1.8±1.3）°， and the control group had radial shortening after fracture healing as （3.2±1.5）°， and the difference had statistical significance between the two groups （t=-4.113， P<0.05）. The observation group had total incidence of postoperative complications as 26.5%， and the control group had total incidence of postoperative complications as 23.5%. There was no statistically significant difference between the two groups （χ2=0.078， P>0.05）. Conclusion Implement of surgical treatment for senile distal radius fracture can provide excellent functional reduction and early reduction， while conservative treatment and surgical treatment can both show long-term function rehabilitation effect， along with precise safety.

【Key words】 Conservative treatment； Surgical treatment； Distal radius fracture； Senile

桡骨远端骨折的发生率约为急诊骨科患者的17%， 通常发生在距桡骨远端腕关节面3 cm以内[1]。桡骨远端骨折治疗通常采用手法复位外固定保守治疗或者切开复位内固定手术治疗， 但对于临床的治疗效果在医学界仍存在着较大的争议[2]。……