Coony Ⅱ型桡骨远端骨折的手术与保守治疗Coony type Ⅱ distal radius fracture: surgery versus conservative treatment
孙兆旭;吴萤;卢建峰;尹海磊;卢廷胜;张伟;
摘要(Abstract)：
[目的]比较CoonyⅡ型桡骨远端骨折手术与保守治疗的疗效,为临床合理诊疗提供依据。[方法]对2013年3月~2015年4月本院收治的CoonyⅡ型桡骨远端骨折患者106例进行临床对照研究。按照治疗方式分为2组,分别采用切开复位"T"型解剖钢板内固定(手术组)和手法复位联合塑形小夹板外固定(保守组)治疗方式,比较2组治疗后碗部疼痛情况、腕关节功能及患者的生活质量。[结果]106例患者均完成1年的随访。手术组全部患者得到解剖复位,有1例术后出现Sudeck骨萎缩;而保守组l0例畸形愈合,其中3例患者因夹板松脱等原因未能及时来院复查,致骨折畸形严重,功能较差。在治疗后6周,3、6个月随访时间点,手术组Gartland-Werley(GW)评分和PRWE评分均优于保守组,比较结果差异有统计学意义(P<0.05),但随着随访时间延长,差异逐渐减小,在1年随访时,两种治疗方法治疗效果比较差异无统计学意义(P>0.05)。[结论]手术治疗与保守治疗CoonyⅡ型桡骨远端骨折均可取得较好疗效,与保守治疗相比,手术治疗可实现解剖复位和坚强固定,避免骨折再移位,其早期疗效优势明显,但由于保守治疗方法简单、费用低廉、患者痛苦较小,所以实际临床工作中需要综合考虑患者的功能需求、年龄以及经济情况等因素,制定个性化治疗策略。
关键词(KeyWords)： 桡骨远端关节外骨折;桡腕关节;骨科手法;骨折固定术;手术后并发症
基金项目(Foundation):
作者(Author): 孙兆旭;吴萤;卢建峰;尹海磊;卢廷胜;张伟;
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DOI:
参考文献(References)：
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