目的 观察两种方法治疗不稳定型桡骨远端骨折（unstable distal radius fractures, UDRF）的临床效果。方法 选取2016年1月—2020年12月间120例UDRF患者,其中A组60例给予切开复位钢板内固定治疗,B组60例给予闭合复位外固定架治疗,术后随访3个月,观察两组患者骨折愈合时间、并发症发生情况,以GW（Gartland and Werley）评分系统评估两组患者的腕关节功能恢复情况,并对两组治疗费用进行对比。结果 A组骨折愈合时间明显长于B组（t=4.065 4, P=0.000 1）;A组并发症总发生率与B组相比,无统计学差异（χ²=0.138 9, P=0.709 4）;术后3个月A组GW评分优良率略高于B组,但不具有统计学差异（χ²=0.890 5, P=0.345 3）;A组治疗费用明显高于B组（t=5.8966, P<0.001）。结论 上述两种方法治疗UDRF均可获得较满意的近期疗效,但闭合复位外固定架治疗费用较低,骨折愈合时间更短。

Objective To observe the clinical effects of two approaches on unstable distal radius fracture （UDRF）. Methods From January 2016 through December 2020, 120 patients with UDRF were selected. Among them, 60 cases （group A） received open reduction and steel plate internal fixation, and another 60 cases （group B） received closed reduction and external fixation. After 3 months of follow-up, fracture healing time, complications, wrist joint function recovery （assessed by Gartland and Werley, GW, scoring system）, and treatment cost were compared between the two groups. Results The fracture healing time of group A was significantly longer than that of group B （t=4.065 4, P=0.000 1）. There was no statistical difference in the total incidence rate of complications between the two groups （χ²=0.138 9, P=0.709 4）. After 3 months of operation, the excellent and good rate of GW score in group A was slightly higher than that in group B, without statistical difference （χ²=0.890 5, P=0.345 3）. The treatment cost of group A was significantly higher than that of group B （t=5.896 6, P<0.001）. Conclusion Both of the selected two methods can achieve satisfactory short-term effect on UDRF, but closed reduction and external fixation features lower treatment cost and shorter fracture healing time.