| 朱雪柯,蔺婷婷,贾梦荻.腕关节镜下骨折复位内固定与闭合复位支架外固定治疗桡骨远端关节内粉碎性骨折疗效对比[J].中国烧伤创疡杂志,2023,(5):367~370. |
| DOI： |
| 中文关键词: 腕关节镜 骨折复位内固定 闭合复位支架外固定 桡骨远端关节内粉碎性骨折 腕关节功能 |
| 英文关键词:Wrist arthroscopy Fracture reduction and internal fixation Closed reduction and stent external
fixation Distal radial intra-articular comminuted fracture Function of wrist joint |
| 基金项目: |
|
| 摘要点击次数: 1367 |
| 全文下载次数: 4276 |
| 中文摘要: |
| 【摘要】 目的 对比分析腕关节镜下骨折复位内固定与闭合复位支架外固定治疗桡骨远端关节内粉碎性骨折的临床效果。 方法 选取 2020 年 3 月至 2022 年 3 月河南科技大学第一附属医院收治的 86 例桡骨远端关节内粉碎性骨折患者作为研究对象, 按照不同治疗方法将其分为关节镜组 (47 例) 和闭合复位组 (39 例), 关节镜组患者采用腕关节镜下骨折复位内固定治疗, 闭合复位组患者采用闭合复位支架外固定治疗, 对比观察两组患者手术时间、住院时间、骨折愈合时间、腕关节功能、临床疗效以及并发症发生情况。 结果 关节镜组患者手术时间、住院时间和骨折愈合时间均明显长于闭合复位组 ( t = 19. 311、3. 333、2. 069, P < 0. 001、P = 0. 001、P =0. 042)。 术后 3 个月, 关节镜组患者腕关节旋前、旋后、掌屈、背伸、尺偏、桡偏活动度均明显大于闭合复位组(t = 7.820、4.299、3.515、3.740、3.643、5.066, P 均 < 0.001), Cooney 腕关节评分明显高于闭合复位组 ( t =6. 194, P < 0. 001); 关节镜组患者中腕关节功能恢复为优 22 例、良 20 例、可 3 例、差 2 例, 明显优于闭合复位组患者的腕关节功能恢复为优 12 例、良 16 例、可 8 例、差 3 例 (Z = - 1. 994, P = 0. 046)。 关节镜组患者术后并发症发生率为 4.26% , 明显低于闭合复位组患者的术后并发症发生率 17. 95% ( χ2= 4. 265, P = 0. 039)。 结论 与闭合复位支架外固定相比, 腕关节镜下骨折复位内固定治疗桡骨远端关节内粉碎性骨折虽存在手术时间长、骨折愈合缓慢等问题, 但腕关节功能恢复效果更好, 临床疗效更佳, 术后并发症发生率更低。 |
| 英文摘要: |
| 【Abstract】 Objective To compare the clinical efficacy of wrist arthroscopic reduction / internal fixation and closed reduction / stent external fixation in the treatment of distal radial intra?articular comminuted fracture. Methods 86 patients with distal radial intra?articular comminuted fracture admitted into The First Affiliated Hospital of Henan University of Science and Technology between March 2020 and March 2022 were enrolled as research subjects, and divided into arthroscopic group (n = 47) and closed reduction group (n = 39) based on different treatments they received. Patients in the arthroscopicgroup were treated with wrist arthroscopic reduction and internal fixation, while patients were treated with closed reduction and stent external fixation in the closed reduction group. The operation time, length of stay, fracture healing time, functions of wrist joint, clinical efficacy and occurrence of complications were compared between the two groups. Results The operation time, length of stay and fracture healing time of patients in the arthroscopic group were obviously longer than that in the closed reduction group (t = 19.311, 3.333 and 2.069, P < 0.001, P = 0.001, P = 0.042). Three months after surgery, the ranges of motion of pronation, supination, palmar flexion, back stretch, ulnar deviation and radial deviation were all significantly larger in the arthroscopic group compared with the closed reduction group (t = 7.820, 4.299, 3.515, 3.740,3.643 and 5.066, all P < 0.001), the Cooney wrist score was obviously higher in the arthroscopic group (t = 6.194, P <0.001). The functional restoration of wrist joint of patients was evaluated as excellent in 22 cases, good in 20 cases, fair in 3 cases and poor in 2 cases in the arthroscopic group, which was markedly better than that in the closed reduction group (Z = - 1.994, P = 0.046) - excellent in 12 cases, good in 16 cases, fair in 8 cases and poor in 3 cases. The incidence of postoperative complications was 4.26% in the arthroscopic group, being obviously lower than the corresponding 17.95% in the closed reduction group (χ2= 4.265, P = 0.039). Conclusion Compared with the closed reduction and stent external fixation, the wrist arthroscopic reduction and internal fixation in the treatment of distal radial intra?articular comminuted fracture can realize better functional restoration of wrist joint, superior clinical efficacy, and less occurrence of postoperative complications, though with the disadvantages of longer operation time and slower fracture healing. |
|
|
|
|
