桡骨远端关节内骨折中克氏针石膏固定与锁定钢板固定的疗效比较

Outcomes of pin and plaster versus locking plate in distal radius intraarticular fractures.

作者信息

Bahari-Kashani Mahmoud, Taraz-Jamshidy Mohammad Hosein, Rahimi Hassan, Ashraf Hami, Mirkazemy Masoud, Fatehi Amirreza, Asadian Mariam, Rezazade Jafar

机构信息

Mashhad Orthopedic and Trauma Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.

Department of Orthopedic Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.

出版信息

Trauma Mon. 2013 Winter;17(4):380-5. doi: 10.5812/traumamon.7951. Epub 2013 Jan 15.

DOI:10.5812/traumamon.7951

PMID:24350132

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3860657/

Abstract

BACKGROUND

Distal radius fractures are among the most prevalent fractures predictive of probable occurrence of other osteoporotic fractures. They are treated via a variety of methods, but the best treatment has not been defined yet.

OBJECTIVES

This study was performed to compare the results of open reduction and internal fixation with locking plates versus the pin and plaster method.

MATERIALS AND METHODS

In this prospective study, 114 patients aged 40 to 60 years with Fernandez type III fracture referring to Imam-Reza and Mehr hospitals of Mashhad from 2009 to 2011, were selected randomly; after obtaining informed consent, they were treated with pin and plaster fixation (n = 57) or internal fixation with the volar locking plate (n = 57). They were compared at the one year follow up. Demographic features and standard radiographic indices were recorded and MAYO, DASH and SF - 36 tests were performed. Data was analyzed by SPSS software version 13, with descriptive indices, Mann-Whitney and Chi-square tests.

RESULTS

SF-36 test demonstrated a better general health (P < 0.001), mental health (P = 0.006), physical functioning (P < 0.001), social functioning (P < 0.001) and energy/fatigue (P < 0.001) in LCP group. However, pain (P = 0.647) was not significantly different between the groups. Physical limitation (P < 0.001) and emotional limitation (P < 0.001) were greater in the pin and plaster group. Also, in the LCP group mean MAYO score (P < 0.001) was more than pin and plaster group. Mean DASH score was not different between the groups (P = 0.218). The rate of acceptable results of radiographic indices (P < 0.001), grip strength (P < 0.001) and range of motion in supination-pronation (P < 0.001) in LCP method were better than the pin and plaster method.

CONCLUSIONS

In treatment of intra-articular distal radius fractures in middle-aged patients internal fixation with locking plates may be prefered to pin and plaster as the treatment of choice.

摘要

背景

桡骨远端骨折是最常见的骨折类型之一，可预测其他骨质疏松性骨折的可能发生。其治疗方法多种多样，但最佳治疗方法尚未确定。

目的

本研究旨在比较锁定钢板切开复位内固定与钢针石膏固定方法的治疗效果。

材料与方法

在这项前瞻性研究中，随机选取2009年至2011年期间在马什哈德伊玛目·礼萨医院和梅尔医院就诊的114例年龄在40至60岁之间的费尔南德斯III型骨折患者；在获得知情同意后，他们分别接受钢针石膏固定（n = 57）或掌侧锁定钢板内固定（n = 57）治疗。在随访一年时对两组进行比较。记录人口统计学特征和标准影像学指标，并进行梅奥、DASH和SF - 36测试。数据采用SPSS 13软件进行分析，使用描述性指标、曼-惠特尼检验和卡方检验。

结果

SF - 36测试显示锁定加压钢板（LCP）组在总体健康状况（P < 0.001）、心理健康（P = 0.006）、身体功能（P < 0.001）、社会功能（P < 0.001）和精力/疲劳（P < 0.001）方面表现更好。然而，两组之间的疼痛程度（P = 0.647）无显著差异。钢针石膏组的身体限制（P < 0.001）和情感限制（P < 0.001）更大。此外，LCP组的平均梅奥评分（P < 0.001）高于钢针石膏组。两组之间的平均DASH评分无差异（P = 0.218）。LCP方法在影像学指标可接受率（P < 0.001）、握力（P < 0.001）和旋前-旋后活动范围（P < 0.001）方面均优于钢针石膏方法。