Barton骨折不同治疗方式临床疗效研究

Barton骨折不同治疗方式临床疗效研究

招卫乾

(广州市白云区石井人民医院外科，广东 广州 510000)

摘要：目的 探讨外固定架固定和切开复位内固定2种治疗方法在Barton骨折治疗中的疗效。方法 回顾性分析2012~2014年行手法复位夹板外固定术(对照组)、手法复位或克氏针撬拨复位后外固定架固定术(外固定架固定组)和切开复位 T 型钛板内固定术(切开复位内固定组)的58例Barton 骨折的临床资料，比较各组骨折复位情况和腕关节功能恢复情况。结果 对照组骨折解剖复位优良率和腕关节功能恢复优良率分别为44.4%、50.0%，外固定架固定组分别为85.0%、75.0%，切开复位内固定组均为90.0%。切开复位内固定组和外固定架固定组的骨折解剖复位优良率、腕关节功能恢复优良率明显高于对照组，差异均有显著性意义(P<0.01)；切开复位内固定组和外固定架固定组骨折解剖复位优良率比较，两组差异无显著性(P>0.05)；切开复位内固定术组腕关节功能恢复优良率明显优于外固定架固定组，差异有显著性(P<0.05)。结论 手法复位或克氏针撬拨复位后外固定架固定术和切开复位T 型钛板内固定术均是治疗Barton骨折较为理想的方法，切开复位T型钛板内固定术更利于患者腕关节功能的早期恢复。

关键词：Barton骨折；外固定架；T 型钛板；临床疗效

中图分类号：R681.7

文献标识码：A

文章编号：2095-4646(2015)04-0290-03

ABSTRACT：Objective To investigate the application value offixed and ORIF fixation in Barton Fractures. Methods A retrospective analysis of 58 cases of T-type titanium Barton fractures from 2012~1014 was performed.The clinical data of patients withmanual reduction splint external fixation，external fixation surgery or open reduction internal fixation and were analyzed and the situation and wrist function recovery were compared.Results Anatomic reduction rate and excellent good wrist function recovery rate were 44.4% and 50.0% in control group，respectively，85.0% and 75.0% in external fixation group，and both 90.0% in ORIF group.Excellent anatomical reduction rate and good wrist function recovery in internal fixation group and external fixation group were significantly higher than those of control group，and the difference was significant (P<0.05 or P<0.01).Excellent anatomic reduction had no significant difference between open reduction fixed group and the external fixation group (P>0.05).Excellent wrist function recovery in open reduction and internal fixation group was significantly better than that of external fixation group，and the difference was significant(P<0.05).Conclusion External fixation and open reduction and internal fixation T-titanium plate fixation is an ideal methodfor Barton fracturestreatment，and open reduction and internal fixation T-titanium is more conducive to patients with early wrist function recovery.

收稿日期：(2015-04-20)

Clinical Efficacy of Different Ways of Barton Fracture Treatment

ZHAO Wei-qian

(ShijingpeoplesHospitalofBaiyunDistrict，GuangzhouCity,GuangzhouGuangdong510000,China)

KEY WORDS：Barton fracture；External fixator；T-titanium；Clinical efficacy

Barton 骨折一种是较为常见的桡骨远端关节内骨折，占桡骨远端骨折的 0.7%～10.7%[1]。传统的治疗方式主要是手法复位后夹板或石膏外固定等，由于不能完全恢复腕关节正常的解剖关系，骨折端在水肿消退后易发生移位，远期骨折延迟愈合、腕关节功能障碍、患腕畸形愈合等发生率较高，疗效欠佳。本研究通过回顾性分析手法复位或克氏针撬拨复位后外固定架固定和切开复位 T 型钛板内固定2种方法在 Barton 骨折治疗中的临床疗效，比较其不足与优势，旨在为临床提供指导。……