[1]汤智,熊辉,姜升平,等.手法复位夹板外固定与切开复位内固定治疗三踝骨折的疗效比较[J].中医正骨,2018,30(03):27-30.
　TANG Zhi,XIONG Hui,JIANG Shengping,et al.A clinical comparison of manipulative reduction and splint external fixation versus open reduction and internal fixation for treatment of trimalleolar fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(03):27-30.
点击复制

手法复位夹板外固定与切开复位内固定治疗三踝骨折的疗效比较()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期数:
2018年03期
页码:
27-30
栏目:
临床研究
出版日期:
2018-03-20

文章信息/Info

Title:
A clinical comparison of manipulative reduction and splint external fixation versus open reduction and internal fixation for treatment of trimalleolar fractures
作者:
汤智1; 熊辉2; 姜升平1; 曹慎1; 蒲云青1; 张旭桥1; 周彪2
1.湖南省湘潭市中医医院,湖南 湘潭 411100; 2.湖南中医药大学,湖南 长沙 410208
Author(s):
TANG Zhi1; XIONG Hui2; JIANG Shengping1; CAO Shen1; PU Yunqing1; ZHANG Xuqiao1; ZHOU Biao2
1.Xiangtan Hospital of Traditional Chinese Medicine,Xiangtan 411100,Hunan,China 2.Hunan Chinese Medical University,Changsha 410208,Hunan,China
关键词:
骨折;  踝关节;  正骨手法;  小夹板固定;  骨折固定术; 内;  桃红四物汤
Keywords:
Keywords fractures; bone;  ankle joint;  bone setting manipulation;  small splint fixation;  fracture fixation;  internal;  Taohong Siwu Tang
摘要:
目的:比较手法复位夹板外固定与切开复位内固定治疗三踝骨折的临床疗效。方法:2016年1—10月纳入三踝骨折患者60例,随机分为2组,每组30例。在口服桃红四物汤的基础上,分别采用手法复位夹板外固定和切开复位解剖钢板加空心钉内固定治疗。记录并比较2组患者的住院时间、下地时间、住院总费用、骨折愈合时间及治疗后1年的Baird-Jackson踝关节评分。结果:2组患者均顺利完成治疗。手法复位夹板外固定组较切开复位内固定组住院时间短、下地时间早、住院总费用少[(15.1±1.0)d,(21.3±1.4)d,t=-23.007,P=0.000;(28.2±1.6)d,(30.4±1.7)d,t=4.634,P=0.000;(5 183.4±551.9)元,(16 151.7±716.5)元,t=-65.631,P=0.000]。2组患者均获随访,随访时间1年; 骨折均愈合,手法复位夹板外固定组骨折愈合时间较切开复位内固定组短[(3.10±0.2)个月,(3.53±0.5)个月,t=-3.317,P=0.004]。治疗后1年2组Baird-Jackson踝关节评分比较,组间差异无统计学意义[(92.2±1.8)分,(91.4±2.6)分,t=1.541,P=0.134]。结论:手法复位夹板外固定与切开复位内固定治疗三踝骨折,二者疗效相当,但前者骨折愈合时间短、住院时间短、下地时间早、住院费用低。
Abstract:
ABSTRACT Objective:To compare the clinical effects of manipulative reduction and splint external fixation versus open reduction and internal fixation in treatment of trimalleolar fractures.Methods:Sixty patients with trimalleolar fractures were included from January 2016 to October 2016 and were randomly divided into 2 groups,30 cases in each group.All of the patients were treated with oral application of Taohong Siwu Tang(桃红四物汤,THSWT),moreover,the patients were treated with manipulative reduction and splint external fixation(group A)and open reduction and internal fixation(group B)respectively.Hospital stay,bed rest time,total cost of hospitalization,fracture healing time and posttreatment Baird-Jackson ankle scores were recorded and compared between the 2 groups.Results:The treatment were finished successfully in all patients.The hospital stay and the bed rest time were shorter and the total cost of hospitalization was less in group A compared to group B(15.1+/-1.0 vs 21.3+/-1.4 days,t=-23.007,P=0.000; 28.2+/-1.6 vs 30.4+/-1.7 days,t=4.634,P=0.000; 5 183.4+/-551.9 vs 16 151.7+/-716.5 RMB,t=-65.631,P=0.000).All patients in the 2 groups were followed up for 1 year and all fractures healed.The fracture healing time was shorter in group A compared to group B(3.10+/-0.2 vs 3.53+/-0.5 months,t=-3.317,P=0.004).There was no statistical difference in Baird-Jackson ankle scores between the 2 groups at one year after treatment(92.2+/-1.8 vs 91.4+/-2.6 points,t=1.541,P=0.134).Conclusion:Manipulative reduction and splint external fixation is similar to open reduction and internal fixation in the curative effects in treatment of trimalleolar fractures,while the former has the advantages of shorter fracture healing time,shorter hospital stay shorter bed rest timer and less total cost of hospitalization.

参考文献/References:

[1] PINCUS D,VELJKOVIC A,ZOCHOWSKI T,et al.Rate of and risk factors for Intermediate-Term reoperation after ankle fracture fixation:a Population-Based cohort study[J].J Orthop Trauma,2017,31(10):315-320.
[2] SU AW,LARSON AN.Pediatric ankle fractures concepts and treatment principles[J].Foot Ankle Clin,2015,20(4):705.
[3] GOOST H,WIMMER MD,BARG A,et al.Fractures of the ankle joint investigation and treatment options[J].Dtsch Arztebl Int,2014,111(21):377-388.
[4] 刘云鹏,刘沂.骨与关节损伤和疾病的诊断分类及功能评定标准[M].北京:清华大学出版社,2002:95-96.
[5] 胥少汀,葛宝丰,徐印坎.实用骨科学[M].4版.北京:人民军医出版社,2012:796-799.
[6] 郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:350.
[7] BAIRD RA,JACKSON ST.Fractures of the distal part of the fibula with associated disruption of the deltoid ligament-treatment without repair of the deltoid ligament[J].J Bone Joint Surg Am,1987,69(9):1346-1352.
[8] 黎文,龙志雄,余楠生,等.踝关节骨折脱位的治疗[J].中国创伤骨科杂志,2010,2(3):193-196.
[9] 李光阳,吴祥宗,陶志东,等.改良外侧入路在三踝骨折切开复位内固定术中的应用[J].中医正骨,2015,27(5):48-49.
[10] 王慧彪,塔依尔·牙合甫.切开复位内固定治疗旋后、旋前外旋型Ⅳ度踝关节骨折[J].中医正骨,2017,29(10):78-80.
[11] 温建民.踝关节损伤治疗方案的选择[J].中国骨伤,2016,29(12):1074-1077.
[12] 王哲.四肢长骨骨折内固定取出术后再骨折的原因分析与临床治疗[D].济南:山东中医药大学,2014.
[13] 谢虎,张继平,陈新,等.手法复位结合石膏固定治疗踝部骨折45例[J].河南中医,2015,35(1):79-80.
[14] 丑钢,张汉庆,李宏军,等.手法复位治疗三踝骨折脱位的临床观察[J].中国中医骨伤科杂志,2007,15(2):56-57.
[15] 熊辉,李前,谈立明,等.桃红四物汤有效成分的交互作用及其对血清VEGF浓度的影响[J].中医正骨,2011,23(2):3-6.

相似文献/References:

[1]鲁建作,林央央,杨杰,等.皮质骨螺钉内固定治疗下胫腓联合分离的CT研究[J].中医正骨,2015,27(11):13.
　LU Jianzuo,LIN Yangyang,YANG Jie,et al.Internal fixation with cortical bone screws for the treatment of distal tibiofibular syndesmosis separation:a CT study of 32 patients[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(03):13.
[2]伍辉国,江克罗,张文正,等.手法复位杉树皮小夹板固定治疗儿童闭合性指骨骨折[J].中医正骨,2015,27(10):63.
[3]孙群周.组合式外固定器固定结合有限内固定治疗 GustiloⅢ型胫骨开放性骨折[J].中医正骨,2015,27(09):25.
[4]戴国钢,刘剑伟,黄雷,等.运动员反复踝关节扭伤后继发足弓塌陷的原因探讨[J].中医正骨,2015,27(09):61.
[5]朱旭伟,万春友,张涛,等.外固定架固定结合髓腔内异体骨支撑治疗四肢粉碎性骨折[J].中医正骨,2015,27(12):68.
[6]杨少辉,许红霞,邢健昆.正骨伸筋胶囊在膝关节周围骨折术后康复中的应用[J].中医正骨,2015,27(02):43.
[7]谭新欢,毕宏政,聂伟志,等.SandersⅡ型跟骨骨折手法复位克氏针 内固定术中植骨的临床研究[J].中医正骨,2015,27(06):6.
　TAN Xinhuan,BI Hongzheng,NIE Weizhi,et al.Clinical research on bone grafting after manipulative reduction and kirschner wire internal fixation for treatment of sandersⅡcalcaneal fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(03):6.
[8]林全艺,丁振贝,陈庆运,等.弹性髓内钉内固定治疗儿童四肢长骨干骨折[J].中医正骨,2015,27(03):52.
[9]董乐乐,连建强.生物学内固定原则在手术治疗长骨骨折不愈合中的应用[J].中医正骨,2013,25(03):73.
[10]王金华,陈建龙,张军,等.加压钢板内固定治疗儿童胫腓骨开放性骨折[J].中医正骨,2012,24(12):40.
[11]茆军,张惠法,严培军,等.Ilizarov外固定支架结合克氏针固定治疗Pilon骨折[J].中医正骨,2015,27(10):32.
[12]许秋群,赵英,何小琴.中医护理在三踝骨折围手术期的应用[J].中医正骨,2016,28(06):74.
[13]宋喜军,滕居赞.后外侧入路联合内侧入路切开复位内固定治疗踝关节骨折合并下胫腓联合分离[J].中医正骨,2016,28(11):53.
[14]谭新欢,李嘉,杨庆民,等.手法复位经皮穿针内固定结合石膏外固定治疗旋后外旋型Ⅱ度踝关节骨折的临床研究[J].中医正骨,2021,33(02):12.
　TAN Xinhuan,LI Jia,YANG Qingmin,et al.A clinical study of manipulative reduction and percutaneous Kirschner wire internal fixation combined with plaster external fixation for treatment of supination-extorsion-type gradeⅡankle fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(03):12.
[15]王琪,郭磊,白平,等.益气续骨合剂加虫类通络方在踝关节骨折术后康复治疗中的应用[J].中医正骨,2021,33(07):17.
　WANG Qi,GUO Lei,BAI Ping,et al.Application of Yiqi Xugu Heji(益气续骨合剂)and Chonglei Tongluo Fang(虫类通络方)to postoperative anke rehabilitation in patients with ankle fractures:a clinical study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(03):17.

备注/Memo

备注/Memo:
基金项目:湖南省自然科学基金项目(2017JJ2256) 通讯作者:熊辉 E-mail:xh_hn@sina.com
更新日期/Last Update: 2018-08-02