| 马文杰,张云鹏,贾松,孙福斋,于志亮.关节镜联合切开复位治疗老年桡骨远端骨折疗效分析[J].老年医学与保健,2025,31(6):1511-1517 |
| 关节镜联合切开复位治疗老年桡骨远端骨折疗效分析 |
| Analysis of therapeutic effect of arthroscopy combined with open reduction in treatment of distal radius fractures in the elderly |
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| DOI：10.3969/j.issn.1008-8296.2025.06.019 |
| 中文关键词: 腕关节镜 老年 桡骨远端骨折 三角纤维软骨复合体损伤 视觉模拟评分 Cooney腕关节功能评分 |
| 英文关键词: wrist arthroscopy elderly distal radius fracture triangular fibrocartilage complex injury visual analog scale Cooney functional score |
| 基金项目:20241115:河北省医学科学研究课题 |
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| 中文摘要: |
| 目的 探讨腕关节镜联合切开复位内固定术治疗桡骨远端骨折合并三角纤维软骨复合体(TFCC)损伤老年患者的疗效.方法 采用回顾性队列研究方法,分析2022 年6 月至2024 年5 月唐山市第二医院接受治疗的87 例桡骨远端骨折合并TFCC老年患者临床资料.根据手术方法分为2 组,其中对照组41 例进行传统切开复位内固定手术治疗,研究组46 例进行腕关节镜结合传统切开复位内固定术治疗.比较2 组手术相关指标、术前及术后12 个月关节活动度、视觉模拟量表(VAS)疼痛评分、Cooney功能评分及并发症情况.结果 研究组手术时间长于对照组,术中出血量少于对照组;术后12 个月,研究组掌倾角、尺偏角均大于对照组,桡骨缩短距离小于对照组(P均＜0.05).术后 12 个月,研究组术后VAS评分(2.26±0.86)明显低于对照组(3.76±1.02);研究组术后Cooney 评分(90.02±8.70)明显高于对照组(85.61±7.16).研究组关节炎及关节面不平整的发生率低于对照组,差异有统计学意义(P均＜0.05).结论 采用腕关节镜结合切开复位内固定术治疗桡骨远端骨折合并TFCC老年患者,可精确修复关节面,并有效减少腕关节疼痛和并发症的发生. |
| 英文摘要: |
| Objective To investigate the therapeutic effect of wrist arthroscopy combined with open reduction and internal fixation(ORIF)in the treatment of distal radius fractures complicated with triangular fibrocartilage complex(TFCC)injuries in elderly patients.Methods A retrospective cohort study was conducted.The clinical data from 87 elderly patients with distal radius fractures and TFCC injuries treated in Second Hospital of Tangshan City between June 2022 and May 2024 were analyzed.Patients were divided into two groups based on the surgical method.The control group(41 cases)underwent traditional ORIF,while the study group(46 cases)received wrist arthroscopy combined with ORIF.The surgery-related indicators,joint range of motion before the operation and 12 months after the operation,visual analog scale(VAS)pain score,Cooney functional scores and complications were compared between the two groups.Results Compared with the control group,the study group had a longer operative time but less intraoperative blood loss.At 12 months after the operation,the palmar-tilt angle and ulnar deviation angle in the study group were both greater than those in the control group,and the radius shortening distance was shorter than that in the control group(all P＜0.05).At 12 months after the operation,the VAS score in the study group(2.26±0.86)was significantly lower than that in the control group(3.76±1.02).The postoperative Cooney functional score in the study group(90.02±8.70)was higher than that in the control group(85.61±7.16).The incidence of arthritis and articular surface irregularities in the study group was significantly lower than that in the control group(all P＜0.05).Conclusion The application of wrist arthroscopy combined with ORIF in the treatment of elderly patients with distal radius fractures and TFCC can precisely repair the articular surface and effectively reduce wrist joint pain and the occurrence of complications. |
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