手法复位石膏外固定与切开复位钢板内固定对骨质疏松性桡骨远端骨折患者腕关节功能和生活质量的影响

目的:比较手法复位石膏外固定与切开复位钢板内固定对骨质疏松性桡骨远端骨折(RDOF)患者腕关节功能和生活质量的影响。方法:按照随机数字表法将2015年6月至2017年6月我院收治的76例RDOF患者分为观察组和对照组,每组各38例。对照组给予手法复位石膏外固定治疗,观察组给予切开复位钢板内固定治疗,比较两组治疗效果、骨折愈合时间、腕关节功能恢复情况、生活质量改善情况及并发症发生情况。结果:观察组患者治疗优良率高于对照组(P0.05)。治疗后1个月,观察组关节背伸、关节曲度高于对照组(P0.05),治疗后3个月比较差异无统计学意义(P0.05);治疗后1个月、3个月观察组掌倾角、尺偏角、握力、桡骨高度均高于对照组,尺骨移位低于对照组,另外,观察组骨折愈合时间短于对照组(P0.05);观察组患者治疗后3个月的躯体健康、躯体角色功能、疼痛、心理功能、情绪角色功能、活力、社会功能、总体健康评分均高于对照组(P0.05);观察组患者并发症总发生率低于对照组(P0.05)。结论:切开复位钢板内固定治疗RDOF疗效优于手法复位石膏外固定,可有效改善患者腕关节功能和生活质量,并发症较少。

Effects of Manual Reduction and Plaster External Fixation and Open Reduction and Internal Fixation on Wrist Function and Quality of Life in Patients with Osteoporotic Distal Radius Fractures

ABSTRACT Objective: To compare the effects of external fixation and open reduction and internal fixation on the wrist joint function and quality of life in patients with osteoporotic distal radius fracture (RDOF). Methods: 76 patients with RDOF who were treated in our hospital from June 2015 to June 2017 were divided into the observation group and the control group according to the random number table method, 38 cases in each group. The control group were treated with manual reduction plus plaster external fixation. The observation group were treated with open reduction and internal fixation. The treatment effect, fracture healing time, wrist function recovery, quality of life improvement and complications were compared between the two groups. Results: The excellent and good rate in the observation group was higher than that in the control group (P<0.05). At 1 months after treatment, the joint dorsiflexion and joint curvature in the observation group were higher than those in the control group (P<0.05), there was no significant difference at 3 months after treatment (P>0.05). At 1 months and 3 months after treatment, the palmar angle, the ulnar angle,the grip strength and the height of the radius were higher than those of the control group, and the ulna displacement was lower than that of the control group, and the fracture healing time was shorter than that of the control group (P<0.05). The scores of physical health, somatic role function, pain, psychological function, emotional role function,vitality, social function and overall health score of the observation group at 3 months after treatment were higher than those of the control group (P<0.05). The incidence of complications in the observation group was lower than that in the control group (P<0.05). Conclusion: The effects of open reduction and plate fixation for RDOF is superior to manual reduction and plaster external fixation. It can effectively improve wrist joint function and quality of life, and it has fewer complications.