闭合复位弹性髓内穿针固定治疗盖氏骨折的临床疗效分析OA

Objective To compare clinical efficacy of closed reduction and elastic intramedullary nail fixation and open reduction and interal fixation with plates and screws in treating Galeazzi fracture.Methods A retrospective analysis was per-formed on clinical data of 46 patients with Galeazzi fractures treated from January 2021 to June 2023.They were divided into intramedullary nail group and plate group according to different treatment methods.There were 26 patients in intramedullary nail group,including 14 males and 12 females,aged from 15 to 50 years old with an average of(28.85±10.56)years old;3 pa-tients with type Ⅰ,15 patients with type Ⅱ and 8 patients with type Ⅲ according to Galeazzi fracture classification;treated with closed reduction and elastic intramedullary needle fixation.There were 20 patienst in tsteel plate group,including 13 males and 7 females,aged from 15 to 52 years old with an average of(31.50±12.36)years old;2 patients with type Ⅰ,12 patients with type Ⅱ and 6 patients with type Ⅲ;treated with conventional open reduction and internal fixation with plates and screws.Oper-ation time,intraoperative blood loss and fracture healing time between two groups were recorded and compared.The degree of pain relief was evaluated by visual analogue scale(VAS)before operation and on the 1st,3rd,7th and 14th days after opera-tion,respectively.The recovery of wrist joint function of affected limb was evaluated by Gartland-Werley score at 12 months af-ter operation.Results Both groups were followed up,and follow-up time of intramedullary nail group ranged from 12 to 16 months with an average of(14.57±3.63)months,and that of plate group ranged from 12 to 19 months with an average of(14.00±3.50)months;there was no statistically significant difference between two groups(P＜0.05).VAS of intramedullary nail group at 1,3,7,and 14 days after operation were(5.23±1.31),(4.00±1.10),(2.43±0.95),and(1.00±0.85)points,re-spectively,which were lower than those of steel plate group(6.05±1.23),(4.80±0.83),(3.45±1.32),and(2.00±1.17),and the differences were statistically significant(P＜0.05).The intraoperative blood loss,operation time and fracture healing time in intramedullary nail group were(33.85±10.98)mL,(76.92±11.41)min and(4.08±1.02)months,respectively,while steel plate groups were(102.50±27.51)mL,(97.25±20.16)min,and(6.20±1.44)months respectively,and there were statistically sig-nificant differences between two groups(P＜0.05).At 12 months after operation,Gartland-Werley scores of wrist joint function in intramedullary nail group and plate group were(6.46±4.74)and(10.45±7.40),respectively,there was no statistically sig-nificant difference between two groups(P＞0.05).Conclusion Closed reduction and elastic intramedullary needle fixation for Galeazzi fractures could effectively relieve postoperative pain,shorten operation time,and accelerate the speed of fracture heal-ing after opertaion.It is a good way to treat Galeazzi fractures.