Chen Jian-liang, Zhang Long-jun, Xu Yong, Zhu Shao-bing, Zheng Xiao-dong
Zhongguo Gu Shang. 2016 Jan;29(1):8-12.
To investigate the feasibility of using percutaneous K-wires fixation after manipulative reduction combining with gypsum or splint fixation for treatment of the Barton fracture of aged people.
From June 2011 to May 2013, 91 patients with closed and fresh Barton fracture were analyzed retrospectively which information was complete. According to different methods these patients were divided into three groups: 33 patients in group A were treated by simplex fixation of gypsum or splint after manipulative reduction, including 20 males and 13 females with an average age of (63.27 ± 5.83) years old; 35 patients in group B were treated by percutaneous K-wires fixation after manipulative reduction combining with gypsum or splint fixation, including 23 males and 12 females with an average age of (64.25 ± 4.53) years old; 23 patients in group C were treated by open reduction and internal fixation including 15 males and 8 females with an average age of (64.04 ± 4.83) years old.
All the patients were followed up for 10 to 16 months with an average of 12 months by the method of recheckging in outpatient clinic. According Dienst scoring system: in group A, the result was excellent in 15 cases, good in 7 cases, fair in 11 cases; in group B, excellent in 25 cases, good in 6 cases, fair in 4 cases; in group C, excellent in 16 cases, good in 5 cases, fair in 2 cases. The excellent and good rate of group C was better than that of group B and A, further more group B is better than group A. According to X- ray standard, in group A, 26 patients were acceptable, 7 patients were unacceptable; in group B,28 patients were acceptable, 7 patients were uacceptable; in group C, 19 patients were acceptable,4 patients were unacceptable; there were no statistical significant difference (P > 0.05). There were 18 patients with emerging recrispation in group A, 10 patients in group B, 6 patients in group C, the result of group B and C was better than that of group A, and there was no statistically significant between group B and C (P > 0.05).
Using percutaneous K-wires fixation after manipulative reduction combining with gypsum or splint fixation for treatment of the Barton fracture of aged people is an effective method, it has advantages of micro-invasived, reliable fixation, less complication, not need to fix wrist joint and early functional exercise.
探讨手法复位后经皮克氏针固定联合石膏或夹板固定治疗老年人巴顿骨折的可行性。
回顾性分析2011年6月至2013年5月期间资料完整的91例闭合性新鲜巴顿骨折患者。根据治疗方法不同将患者分为三组：A组33例，采用手法复位后单纯石膏或夹板固定，其中男20例，女13例，平均年龄（63.27±5.83）岁；B组35例，采用手法复位后经皮克氏针固定联合石膏或夹板固定，其中男23例，女12例，平均年龄（64.25±4.53）岁；C组23例，采用切开复位内固定，其中男15例，女8例，平均年龄（64.04±4.83）岁。
所有患者均采用门诊复查的方式随访10～16个月，平均12个月。根据 Dienst评分系统：A组优15例，良7例，可11例；B组优25例，良6例，可4例；C组优16例，良5例，可2例。C组的优良率优于B组和A组，且B组优于A组。按照X线标准：A组26例复位满意，7例不满意；B组28例复位满意，7例不满意；C组19例复位满意，4例不满意；差异无统计学意义（P＞0.05）。A组有18例出现再移位，B组10例，C组6例，B组和C组的结果优于A组，且B组和C组之间差异无统计学意义（P＞0.05）。
手法复位后经皮克氏针固定联合石膏或夹板固定治疗老年人巴顿骨折是一种有效的方法，具有微创、固定可靠、并发症少、无需固定腕关节及可早期功能锻炼等优点。
