Wang Jing, Chen Jian-hai, Jiang Bao-guo
Department of Orthopaedics and Trauma, People's Hospital, Peking University, Beijing 100044, China.
Zhonghua Wai Ke Za Zhi. 2009 Sep 15;47(18):1387-9.
To explore the clinical relative factors on the therapeutic effect of wrist joint function in patients with type-C fractures of distal radius treated with internal fixation.
Retrospectively collect consecutive patients of type-C fractures of distal radius treated surgically with open reduction and internal fixation admitted from January 2001 to October 2007. Making Gartland and Werley Score of wrist joint function as the primary outcome variable, the following were assessed: the postoperative efficacy at the follow-up, and use non-conditional Logistic regression to analysis the correlation of wrist joint function with patients' age, gender, time from injury to operation, classifications of type-C fracture, methods of internal fixation and other clinical factors.
In this study, 56 patients met the inclusion were collected. The follow-up time was 3.1 to 29.2 months (mean follow-up 6.3 months). The result of Gartland and Werley Score: 24 patients were excellent, good 26, fair 3, and poor 3; the excellent and good rate was 89.29%. Monovariant and multivariant Logistic regression analysis demonstrated that postoperative efficacy was significantly associated with elder age, time from injury to operation, methods of internal fixation:age (OR = 4.64; 95%CI: 1.48 - 14.54; P = 0.009), time from injury to operation (OR = 9.00; 95%CI: 1.72 - 46.99; P = 0.009), methods of internal fixation (OR = 3.33; 95%CI: 1.10 - 10.12; P = 0.034).
Elder age (>or= 65 years) and delay of surgery (>or= 13 d) are the influential factors of postoperative functional outcome of distal radius fractures. For the treatment of intra-articular type-C fractures of distal radius, locking compression plate is more effective than T-type plate.
探讨采用内固定治疗的桡骨远端C型骨折患者腕关节功能治疗效果的临床相关因素。
回顾性收集2001年1月至2007年10月收治的采用切开复位内固定手术治疗的桡骨远端C型骨折连续病例。将腕关节功能的Gartland和Werley评分作为主要结局变量，评估以下内容：随访时的术后疗效，并采用非条件Logistic回归分析腕关节功能与患者年龄、性别、受伤至手术时间、C型骨折分类、内固定方法及其他临床因素的相关性。
本研究共收集符合纳入标准的患者56例。随访时间为3.1至29.2个月（平均随访6.3个月）。Gartland和Werley评分结果：优24例，良26例，可3例，差3例；优良率为89.29%。单因素和多因素Logistic回归分析表明，术后疗效与年龄较大、受伤至手术时间、内固定方法显著相关：年龄（OR = 4.64；95%CI：1.48 - 14.54；P = 0.009），受伤至手术时间（OR = 9.00；95%CI：1.72 - 46.99；P = 0.009），内固定方法（OR = 3.33；95%CI：1.10 - 10.12；P = 0.034）。
年龄较大（≥65岁）和手术延迟（≥13天）是桡骨远端骨折术后功能结局的影响因素。对于桡骨远端关节内C型骨折的治疗，锁定加压钢板比T型钢板更有效。
