Howard P W, Stewart H D, Hind R E, Burke F D
Derbyshire Royal Infirmary, Derby, England.
J Bone Joint Surg Br. 1989 Jan;71(1):68-73. doi: 10.1302/0301-620X.71B1.2915010.
We report a prospective, randomised, controlled trial of 50 severely displaced comminuted Colles' fractures treated by either external fixation or manipulation and plaster. Each patient was assessed radiographically throughout treatment, and functionally by an independent observer at three and six months. The functional result correlated with the anatomical result, which was significantly better in patients treated by external fixation. This resulted in significantly improved function especially in young patients, and also a lower complication rate. We recommend the use of external fixation for young patients with comminuted displaced Colles' fractures unless manipulation and plaster show excellent reduction.
我们报告了一项针对50例严重移位的粉碎性科雷氏骨折患者的前瞻性随机对照试验，这些患者分别接受了外固定或手法复位及石膏固定治疗。在整个治疗过程中，对每位患者进行了影像学评估，并在3个月和6个月时由独立观察者进行功能评估。功能结果与解剖学结果相关，接受外固定治疗的患者解剖学结果明显更好。这导致功能显著改善，尤其是在年轻患者中，并且并发症发生率也更低。我们建议，对于粉碎性移位的科雷氏骨折的年轻患者，除非手法复位及石膏固定显示出极佳的复位效果，否则应使用外固定治疗。
