影像科学与光化学 ›› 2019, Vol. 37 ›› Issue (6): 624-630.DOI: 10.7517/issn.1674-0475.190718

• 综述与论文 • 上一篇    下一篇

老年Colles骨折X线Frykman分型在治疗方案选择中的应用价值探究

任红1, 陈华2   

  1. 1. 上海市闵行区梅陇社区卫生服务中心 放射科, 上海 201104;
    2. 上海市第六人民医院 骨科, 上海 200233
  • 收稿日期:2019-07-25 出版日期:2019-11-15 发布日期:2019-11-15
  • 通讯作者: 陈华

The Application Value of Old Colles Fracture X-ray Frykman Classification in the Choice of Treatment Plan

REN Hong1, CHEN Hua2   

  1. 1. Department of Radiology, Meilong Community Health Service Center, Minhang District, Shanghai 201104, P. R. China;
    2. Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai 200233, P. R. China
  • Received:2019-07-25 Online:2019-11-15 Published:2019-11-15

摘要: 该回顾性研究旨在探究老年Colles骨折X线Frykman分型在治疗方案选择中的应用价值。2015年1月~2018年1月期间收治的120例老年Colles骨折患者纳入研究对象,完善X线检查并进行Frykman分型,比较不同Frykman分型的Colles骨折患者X线掌倾角、尺偏角、桡骨短缩等指标。依据Frykman分型将患者分为关节内、外型骨折,比较两种骨折类型患者治疗方式及X线指标的变化情况,并采用Lidstrom治疗效果分级评估不同分组患者不同治疗方式的治疗效果。结果显示,120例Colles骨折患者根据Frykman分型:Ⅰ型26例(21.67%)、Ⅱ型29例(24.17%)、Ⅲ型14例(11.67%)、Ⅳ型16例(13.33%)、Ⅴ型12例(10.00%)、Ⅵ型11例(9.17%)、Ⅶ型8例(6.67%)、Ⅷ型4例(3.33%)。120例患者中共有关节外型骨折患者55例,其中30例行保守治疗,25例接受手术治疗;关节内型骨折患者65例,其中29例行保守治疗,36例接受手术治疗。两组骨折类型患者治疗后手术治疗的掌倾角、尺偏角、桡骨短缩值均明显优于保守治疗的患者,比较差异均有统计学意义(P<0.05)。关节外型Colles骨折患者治疗总可接受率(72.73%)与关节内型治疗总接受率(75.38%)(χ2=0.11,P=0.74)相当;关节外型组手术治疗总可接受率(88.00%)高于保守治疗(73.33%)(χ2=1.83,P=0.18);关节内型组手术治疗总可接受率(91.67%)明显高于保守治疗(55.17%)(χ2=11.53,P=0.00)。本研究证实老年Colles骨折X线Frykman分型在治疗方案选择中具有应用价值,关节外型骨折患者手术和保守治疗效果相当,关节内型患者优先选择手术治疗。

关键词: Colles骨折, Frykman分型, Lidstrom治疗效果分级

Abstract: This retrospective study was designed to explore the value of X-ray Frykman classification of elderly Colles fractures in the choice of treatment options. 120 elderly patients with Colles fractures admitted between January 2015 and January 2018 were enrolled in the study. X-ray examination and Frykman classification were performed to compare the X-ray palm dip and ulnar angle of patients with different Frykman classifications. According to Frykman classification, patients were divided into intra-articular and external fractures. The treatment methods and X-ray indexes of patients with two types of fractures were compared and the therapeutic effect of different treatments in different groups was evaluated by Lidstrom treatment. The results showed that 120 patients with Colles fracture were classified according to Frykman:26 cases (21.67%) of type I, 29 cases (24.17%) of type Ⅱ, 14 cases (11.67%) of type Ⅲ, and 16 cases (13.33%) of type Ⅳ. 12 cases (10.00%) of type Ⅴ, 11 cases (9.17%) of type Ⅵ, 8 cases (6.77%) of type Ⅶ, and 4 cases (3.33%) of type Ⅷ. Of the 120 patients, 55 patients with extra-articular fractures, of which 30 underwent conservative treatment and 25 underwent surgery; 65 patients with intra-articular fractures, 29 of whom underwent conservative treatment and 36 underwent surgery. The degree of palm dip, ulnar deviation and humeral shortening of surgical treatment after treatment were significantly better than those of conservative treatment (P<0.05). Total acceptable rate of treatment for patients with extra-articular Colles fracture (72.73%) was equivalent to total acceptance rate for intra-articular treatment (75.38%) (χ2=0.11, P=0.74); total acceptable rate of surgical treatment for the extra-articular group (88.00%) was higher than conservative treatment (73.33%) (χ2=1.83, P=0.18); the total acceptable rate of surgery in the intra-articular group (91.67%) was significantly higher than that of conservative treatment (55.17%) (χ2=11.53, P=0.00)). This study confirmed that the X-ray Frykman classification of the elderly Colles fracture has application value in the treatment options. The extra-articular fractures are equivalent to the surgical and conservative treatments. The patients with intra-articular type prefer to surgical treatment.

Key words: Colles fracture, Frykman classification, Lidstrom treatment effect classification