Shen Run-Bin, Li Guo-Liang, Liu Xiao-Ping, Chen Kang, Han Guang-Pu, Zhao Jian-Yong
Minimally Invasive Orthopedics Department, Cangzhou Integrated Traditional Chinese and Western Medicine Hospital, Cangzhou 061000, Hebei, China; Hebei Province Integrated Traditional Chinese and Western Medicine 3D Printing Technology Innovation Center, Cangzhou 061000, Hebei, China.
North China University of Science and Technology, Tangshan 063000, Hebei, China.
Zhongguo Gu Shang. 2025 Jan 25;38(1):25-30. doi: 10.12200/j.issn.1003-0034.20240505.
To investigate the short-term clinical effect of closed reduction single arm external fixator combined with percutaneous needle fixation in the treatment of C1 distal radius fracture in elderly patients.
Between December 2022 and December 2023, a total of 60 elderly patients diagnosed with type C1 distal radius fractures were treated, comprising 9 males and 51 females. The age ranged from 65 to 84 years old, with an average of (72.69±8.14) years old. Among them, there were 18 cases on the left side and 42 cases on the right side. There were 55 cases of falling injury and 5 cases of traffic accident injury. According to the different surgical methods, the patients were divided into observation group and control group, with 30 cases in each group. The control group underwent manual reduction and unilateral external fixator fixation, consisting of 4 males and 26 females. The mean age was (72.54±8.67) years old. The body mass index (BMI) was (20.61±2.17) kg·m. There were 10 cases on the left side and 20 cases on the right side. Among them, there were 27 cases of falling injury and 3 cases of traffic accident injury. The observation group was treated with manual reduction and unilateral external fixator combined with percutaneous Kirschner wire fixation, including 5 males and 25 females. The mean age was (72.76±7.23) years old. BMI (20.82±2.03) kg·m. The left side was involved in 8 cases and the right side in 22 cases. There were 28 cases of falling injury and 2 cases of traffic accident injury. The changes in radial height, ulnar declination, palmar inclination angle parameters and patient-rated wrist evaluation (PRWE) were assessed on X-ray films before surgery, 2 days after surgery, and 12 weeks after surgery between the two groups.
All surgical procedures were successfully completed in both groups without any significant complications. All patients were followed up for a duration from 12 to 20 weeks with an average of(14.50±2.78) weeks. The two groups exhibited significant differences in radial height, palmar inclination angle, and ulnar deviation angle at 2 days and 12 weeks post-operation (<0.05). However, there was no statistically significant difference observed in radial height, palmar inclination, and ulnar deviation between the two groups at 2 days after the operation (>0.05). There were significant differences in radial height, palmar inclination angle, and ulnar deviation between the two groups at 12 weeks after operation (<0.05). At 2 days and 12 weeks after the operation, there were significant differences in PRWE scores of the two groups compared with preoperative scores(<0.05). At 2 days after the operation, there was no significant difference in PRWE score between the two groups (>0.05). The PRWE score showed a significant difference between the two groups at 12 weeks post-operation(<0.05).
The combination of closed reduction and unilateral external fixator, along with percutaneous pin fixation provides move stable fixation for type C1 distal radius fractures. Gradual removal of external fixator further facilitatse the recovery of wrist joint function.
探讨闭合复位单臂外固定器联合经皮穿针固定治疗老年C1型桡骨远端骨折的短期临床疗效。
2022年12月至2023年12月，共治疗60例诊断为C1型桡骨远端骨折的老年患者，其中男性9例，女性51例。年龄65至84岁，平均（72.69±8.14）岁。其中左侧18例，右侧42例。跌倒伤55例，交通事故伤5例。根据手术方法不同，将患者分为观察组和对照组，每组30例。对照组采用手法复位及单侧外固定器固定，其中男性4例，女性26例。平均年龄（72.54±8.67）岁。体重指数（BMI）为（20.61±2.17）kg·m²。左侧10例，右侧20例。其中跌倒伤27例，交通事故伤3例。观察组采用手法复位及单侧外固定器联合经皮克氏针固定，其中男性5例，女性25例。平均年龄（72.76±7.23）岁。BMI为（20.82±2.03）kg·m²。左侧8例，右侧22例。跌倒伤28例，交通事故伤2例。比较两组术前、术后2天及术后12周X线片上桡骨高度、尺偏角、掌倾角参数及患者腕关节评价（PRWE）评分的变化。
两组手术均顺利完成，无明显并发症。所有患者均随访12至20周，平均（14.50±2.78）周。术后2天及12周时，两组桡骨高度、掌倾角及尺偏角比较差异有统计学意义（<0.05）。但术后2天时，两组桡骨高度、掌倾角及尺偏角比较差异无统计学意义（>0.05）；术后12周时，两组桡骨高度、掌倾角及尺偏角比较差异有统计学意义（<0.05）。术后2天及12周时，两组PRWE评分与术前比较差异有统计学意义（<0.05）；术后2天时，两组PRWE评分比较差异无统计学意义（>0.05）；术后12周时，两组PRWE评分比较差异有统计学意义（<0.05）。
闭合复位联合单侧外固定器及经皮穿针固定可为C型桡骨远端骨折提供更稳定的固定。逐步拆除外固定器进一步促进腕关节功能恢复。
