中国骨伤2025，Vol.38Issue(1)：10-17,8.DOI:10.12200/j.issn.1003-0034.20240447
CO接骨架与钢板内固定术治疗不稳定型桡骨远端骨折近期临床疗效比较
Comparison of short-term clinical efficacy between CO external fixation and internal fixation with steel plate in the treatment of unstable distal radius fractures
摘要
Abstract
Objective To evaluate the short-term clinical efficacy of external fixation and internal fixation with steel plate in the treatment of unstable distal radius fractures(AO-23C type),based on the principles of Chinese osteosynthesis(CO).Methods Forty-eight patients with unstable distal radius fractures between January 2022 and February 2023 were retrospec-tively analyzed and divided into the CO external fixation group and internal fixation group.CO external fixation group consisted of 25 patients,including 7 males and 18 females,aged from 37 to 56 years old with an average of(52.6±11.3)years old.A-mong them,there were 7 patients of traffic accidents and 18 patients of falls,resulting in a total of 25 patients of closed frac-tures and no open fractures,the treatment was conducted using closed reduction and CO external fixation.The internal fixation group consisted of 23 patients,comprising 8 males and 15 females,age ranged from 41 to 59 years old,with an average age of(53.3±13.7)years old.Among them,8 patients resulted from car accidents while the remaining 15 patients were caused by falls.All 23 patients were closed fractures without any open fractures observed.The technique of open reduction and internal fixation with steel plate was employed.The perioperative data,including injury-operation time,operation duration,blood loss,and length of hospital stay,were assessed in both groups.Additionally,the QuickDASH score and visual analogue scale(VAS)were evaluated.Range of motion and grip strength assessment,imaging findings such as palmar inclination angle,ulnar decli-nation angle,radius length,articular surface step,intra-articular space measurements were also examined along with any com-plications.Results The follow-up duration ranged from 0 to 24 months,with an average duration of(16.0±3.8)months.The CO external fixation exhibited significantly shorter time from injury to operation(2.4±3.3)d vs(7.4±3.7)d,shorter operation dura-tion(56.27±15.23)min vs(74.10±5.26)min,lower blood loss(14.52±6.54)ml vs(32.32±10.03)ml,and reduced hospital-ization days(14.04±3.24)d vs(16.45±3.05)d compared to the internal fixation group(P＜0.05).The QuickDASH score at 12 months post-operation was(8.21±1.64)in the CO external fixation group,while no significant difference was observed in the internal fixation group(7.04±3.64),P＞0.05.There were no statistically significant differences in VAS between two groups at 6 weeks,as well as 1 and 3 months post-surgery(P＞0.05).Additionally,there were no significant disparities observed in terms of range of motion and grip strength between two groups at the 2-year follow-up after the operation(P＞0.05).After 12 months of surgery,the CO external fixation group exhibited a significantly smaller palmar inclination angle(17.90±2.18)° vs(19.87±3.21)°,reduced articular surface step(0.11±0.03)mm vs(0.17±0.02)mm,and shorter radius length(8.16±1.11)mm com-pared to the internal fixation group(9.59±1.02)mm,P＜0.05.The ulnar deviation angle and intra-articular space did not show any significant difference between two groups(P＞0.05).The reduced fell within the allowable range between the CO external fixation group(23 out of 25 cases)and the internal fixation group(21 out of 23 cases)was not statistically significant(P=0.29).There was no significant difference in complications between the two groups(P＞0.05).Conclusion Both the CO external fixation and open reduction with plate internal fixation demonstrate clinical efficacy in managing unstable distal radius frac-tures.The CO external fixation offers advantages in shorter injury-to-operation times,reduced intraoperative blood loss,and de-creased surgical durations,while radial shortening is more effectively controlled by internal fixation.关键词
桡骨远端骨折/不稳定型/CO接骨架/钢板内固定Key words
Distal radius fractures/Unstable type/CO external fixation/Internal plate fixation分类
医药卫生引用本文复制引用
伏敏睿,史长龙,成永忠,马明明,牛正麟,孙海翔,高景华,吴钟凯,徐一鸣..CO接骨架与钢板内固定术治疗不稳定型桡骨远端骨折近期临床疗效比较[J].中国骨伤,2025,38(1):10-17,8.基金项目
北京市科技计划课题(编号:Z211100002921021)Beijing Municipal Science and Technology Program Project(No.Z211100002921021) （编号:Z211100002921021）
