[1]李玮琳,袁荣霞,但柟林,等.郑氏束带法复位指钢托外固定治疗肿胀期近节指骨骨折的临床研究[J].中医正骨,2025,37(12):14-20.
　LI Weilin,YUAN Rongxia,DAN Nanlin,et al.A clinical study of Zheng's bandage reduction and finger steel splint external fixation for treatment of proximal phalangeal fractures in the swollen phase[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2025,37(12):14-20.
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郑氏束带法复位指钢托外固定治疗肿胀期近节指骨骨折的临床研究()

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第37卷
期数:
2025年12期
页码:
14-20
栏目:
临床研究
出版日期:
2025-12-20

文章信息/Info

Title:
A clinical study of Zheng's bandage reduction and finger steel splint external fixation for treatment of proximal phalangeal fractures in the swollen phase
作者:
李玮琳1; 袁荣霞1; 但柟林2; 谢正虎1
(1.四川省骨科医院,四川 成都 610041; 2.成都体育学院运动医学与健康研究所,四川 成都 610041)
Author(s):
LI Weilin1; YUAN Rongxia1; DAN Nanlin2; XIE Zhenghu1
1.Sichuan Province Orthopedic Hospital,Chengdu 610041,Sichuan,China 2.Institute of Sports Medicine and Health,Chengdu Sport University,Chengdu 610041,Sichuan,China
关键词:
骨折;  手指骨;  牵引术;  正骨手法;  骨折固定术;  随机对照试验专题
Keywords:
fractures; bone;  finger phalanges;  traction;  bone setting manipulation;  fracture fixation;  randomized controlled trials as topic
摘要:
目的:探讨郑氏束带法复位指钢托外固定治疗肿胀期近节指骨骨折的临床疗效。方法:将2022年11月至2023年11月收治的64例肿胀期近节指骨骨折患者随机分为2组,每组32例,分别采用郑氏束带法复位指钢托外固定治疗(郑氏束带法复位组)和传统手法复位指钢托外固定治疗(传统手法复位组)。复位后即刻,参照《手外科手术学》中的复位标准及韩旭等制定的相关复位标准评价骨折复位质量; 分别于拆除外固定后即刻、3个月,采用中华医学会手外科学分会上肢部分功能评定试用标准中总主动活动度(total active movement,TAM)测定法评价患指活动功能; 分别于复位前及拆除外固定后即刻、3个月,采用患者自评腕关节/手部评估量表(the patient-rated wrist/hand evaluation,PRWHE)评定手部功能(PRWHE疼痛评分和PRWHE功能评分)。结果:郑氏束带法复位组和传统手法复位组各有2例患者退出试验。①复位质量。复位后即刻,郑氏束带法复位组骨折复位质量优于传统手法复位组(R^-郑氏束带法复位组=25.42,R^-传统手法复位组=35.58,Z=-2.624,P=0.009)。②TAM。拆除外固定后即刻,2组TAM的差异无统计学意义(Z=-1.090,P=0.276); 拆除外固定后3个月,郑氏束带法复位组TAM优于传统手法复位组(R^-郑氏束带法复位组=27.02,R^-传统手法复位组=33.98,Z=-2.151,P=0.031)。③PRWHE疼痛评分。复位前后不同时间点PRWHE疼痛评分比较,差异无统计学意义(F=1.091,P=0.301); 郑氏束带法复位组PRWHE疼痛评分小于传统手法复位组(F=3 787.703,P=0.000)。④PRWHE功能评分。2组PRWHE功能评分均随时间呈降低趋势(F=1 804.544,P=0.000; F=2 778.929,P=0.000); 复位前,2组PRWHE功能评分的差异无统计学意义; 拆除外固定后即刻、3个月,郑氏束带法复位组PRWHE功能评分均低于传统手法复位组(t=-3.873,P=0.000; t=-2.916,P=0.005)。结论:郑氏束带法复位指钢托外固定治疗肿胀期近节指骨骨折,能够提高即刻复位质量、缓解疼痛、改善患指活动功能、促进手部功能恢复,其疗效优于传统手法复位指钢托外固定。
Abstract:
Objective:To evaluate the clinical efficacy of Zheng's bandage reduction and finger steel splint external fixation in treatment of proximal phalangeal fractures in the swollen phase.Methods:Sixty-four patients with swollen-phase proximal phalangeal fractures,recruited from November 2022 to November 2023,were randomized into 2 groups,with 32 ones in each group,and they were treated with Zheng's bandage reduction and finger steel splint external fixation(Zheng's bandage reduction group),as well as conventional manual reduction and the same external fixation(conventional manual reduction group),respectively.Immediately post-reduction,the quality of fracture reduction was assessed according to the reduction criteria outlined in Operative Hand Surgery and the related standards established by HAN Xu et al.The activity function of the affected finger was evaluated using the total active movement(TAM)method,as stipulated in the Trial Standard for Functional Evaluation of the Upper Limbs developed by the Hand Surgery Society of the Chinese Medical Association,immediately post-removal of external fixator and at 3-month follow-up.Moreover,the hand function was assessed using the patient-rated wrist/hand evaluation(PRWHE),including PRWHE pain score and PRWHE function score,before the reduction,immediately post-removal of external fixator and at the 3-month follow-up.Results:Two patients each in the 2 groups withdrew from the trial.①Quality of fracture reduction.The quality of fracture reduction was better in Zheng's bandage reduction group compared to conventional manual reduction group immediately post-reduction(R^-Zheng's bandage reduction group=25.42,R^-conventional manual reduction group=35.58,Z=-2.624,P=0.009).②TAM.The TAM showed no significant difference between the 2 groups immediately post-removal of external fixator(Z=-1.090,P=0.276),while,3 months following the removal of external fixator,it was higher in Zheng's bandage reduction group compared to the conventional manual reduction group(R^-Zheng's bandage reduction group=27.02,R^-conventional manual reduction group=33.98,Z=-2.151,P=0.031).③PRWHE pain score.The PRWHE pain score showed no significant difference across different time points before and after the reduction(F=1.091,P=0.301),but it was lower in Zheng's bandage reduction group compared to conventional manual reduction group(F=3 787.703,P=0.000).④PRWHE function score.The PRWHE function score presented a decreasing trajectory over time in the 2 groups(F=1 804.544,P=0.000; F=2 778.929,P=0.000).The PRWHE function score showed no significant difference between the 2 groups before the reduction,while,immediately following the removal of external fixator and at 3-month follow-up,it was lower in Zheng's bandage reduction group compared to conventional manual reduction group(t=-3.873,P=0.000; t=-2.916,P=0.005).Conclusion:Zheng's bandage reduction and finger steel splint external fixation can enhance the immediate reduction quality,alleviate the pain,improve the active function of the affected finger,and promote the hand function recovery in treatment of swollen-phase proximal phalangeal fractures.Its therapeutic efficacy is superior to that of conventional manual reduction with the same fixation.

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备注/Memo

备注/Memo:
基金项目:四川省中医药管理局科学技术研究专项课题(2023MS577)
通讯作者:谢正虎 E-mail:49652363@qq.com
(收稿日期:2025-09-22 本文编辑:时红磊)
更新日期/Last Update: 2025-12-20