[1]段星星,马奇翰,高锋,等.纸夹板联合木夹板固定治疗闭合性桡骨远端骨折的临床研究[J].中医正骨,2021,33(05):24-27.
　DUAN Xingxing,MA Qihan,GAO Feng,et al.A clinical study of external fixation with paper splints and wooden splints for treatment of closed distal radius fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(05):24-27.
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纸夹板联合木夹板固定治疗闭合性桡骨远端骨折的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年05期
页码:
24-27
栏目:
临床研究
出版日期:
2021-05-20

文章信息/Info

Title:
A clinical study of external fixation with paper splints and wooden splints for treatment of closed distal radius fractures
作者:
段星星; 马奇翰; 高锋; 李宇卫; 张志刚
(苏州市中医医院,江苏 苏州 215009)
Author(s):
DUAN Xingxing; MA Qihan; GAO Feng; LI Yuwei; ZHANG Zhigang
Suzhou Hospital of Traditional Chinese Medicine,Suzhou 215009,Jiangsu,China
关键词:
桡骨骨折;  骨折; 闭合性;  Colles骨折;  小夹板固定;  石膏; 外科;  临床试验
Keywords:
radius fractures;  fractures; closed;  Colles’fracture;  small splint fixation;  casts; surgical;  clinical trial
摘要:
目的:观察纸夹板联合木夹板固定治疗闭合性桡骨远端骨折的临床疗效。方法:将符合要求的60例闭合性桡骨远端骨折患者随机分为2组,每组30例。手法复位后,联合固定组采用纸夹板联合木夹板固定,石膏固定组采用管形石膏固定。测量患侧桡骨高度、掌倾角、尺偏角,记录骨折愈合时间,采用疼痛视觉模拟量表(visual analogue scale,VAS)评分评价腕部疼痛程度,采用改良Green和O’Brien腕关节评分标准评价综合疗效。结果:治疗前2组患者腕部疼痛VAS评分比较,差异无统计学意义[(8.31±1.24)分,(8.27±1.41)分,t=1.415,P=0.257]; 治疗结束后7 d,联合固定组患者腕部疼痛VAS评分低于石膏固定组[(2.54±0.53)分,(4.27±0.42)分,t=6.132,P=0.018]。所有患者均获随访,随访时间3～12个月,中位数5个月。骨折均愈合,联合固定组的骨折愈合时间短于石膏固定组[(59.58±4.74)d,(70.73±6.37)d,t=8.555,P=0.021]。治疗结束后3个月,联合固定组的患侧桡骨高度高于石膏固定组、掌倾角及尺偏角均大于石膏固定组[(6.15±0.37)mm,(3.93±2.14)mm,t=7.564,P=0.035; 7.52°±2.25°,3.53°±1.94°,t=9.682,P=0.018; 16.44°±3.15°,10.76°±2.58°,t=9.877,P=0.016]; 综合疗效评价,联合固定组优14例、良12例、可4例,石膏固定组优6例、良15例、可8例、差1例,联合固定组的综合疗效优于石膏固定组(Z=-2.322,P=0.020)。结论:纸夹板联合木夹板固定治疗闭合性桡骨远端骨折,可以减轻腕部疼痛、纠正腕部畸形、促进骨折愈合,疗效优于管形石膏固定治疗。
Abstract:
Objective:To observe the clinical curative effects of external fixation with paper splints and wooden splints for treatment of closed distal radius fractures.Methods:Sixty patients with closed distal radius fractures were enrolled in the study and were randomly divided into 2 groups,30 cases in each group.All patients in the 2 groups were treated with manipulative reduction,followed by external fixation with paper splints and wooden splints in 30 cases(combination fixation group)and tubular plaster external fixation in the rest(plaster fixation group).The radial height,volar tilt angles and radial inclination angles were measured,and the fracture healing time was recorded.The wrist pain degree and the total clinical curative effects were evaluated by using pain visual analogue scale(VAS)scores and modified Green and O’Brien wrist scoring criterion respectively.Results:There was no statistical difference in wrist pain VAS scores between the 2 groups before the treatment(8.31±1.24 vs 8.27±1.41 points,t=1.415,P=0.257).The pain VAS scores were lower in combination fixation group compared to plaster fixation group at 7 days after the end of the treatment(2.54±0.53 vs 4.27±0.42 points,t=6.132,P=0.018).All patients in the 2 groups were followed up for 3-12 months with a median of 5 months.All fractures healed in the 2 groups,and the fracture healing time was shorter in combination fixation group compared to plaster fixation group(59.58±4.74 vs 70.73±6.37 days,t=8.555,P=0.021).The radial height was higher,the volar tilt angles and radial inclination angles were larger in combination fixation group compared to plaster fixation group at 3 months after the end of the treatment(6.15±0.37 vs 3.93±2.14 mm,t=7.564,P=0.035; 7.52±2.25 vs 3.53±1.94 degrees,t=9.682,P=0.018; 16.44±3.15 vs 10.76±2.58 degrees,t=9.877,P=0.016).The total clinical curative effects were evaluated at 3 months after the end of the treatment.Fourteen patients obtained an excellent result,12 good and 4 fair in combination fixation group; while 6 patients obtained an excellent result,15 good,8 fair and 1 poor in plaster fixation group.The combination fixation group surpassed the plaster fixation group in total clinical curative effects(Z=-2.322,P=0.020).Conclusion:External fixation with paper splints and wooden splints can relieve wrist pain,correct wrist deformity and promote fracture healing in treatment of closed distal radius fractures,and its curative effect is better than that of tubular plaster external fixation.

参考文献/References:

[1] 徐文停,倪诚,喻任,等.113例绝经后女性腕部骨折的危险因素分析[J].中国骨质疏松杂志,2013,19(9):944-945.
[2] 潘廷明,董忠,杨连梓,等.手法复位石膏外固定联合中药熏洗和切开复位钢板内固定治疗骨质疏松性桡骨远端骨折疗效比较[J].中国中西医结合杂志,2019,39(1):63-66.
[3] 魏立友,李忠民,张文芳,等.小夹板和锁定钢板治疗老年人桡骨远端关节内骨折的比较[J].中国矫形外科杂志,2017,25(24):2238-2243.
[4] 李永耀,赵勇,程灏,等.夹板弹性固定桡骨远端FrykmanⅧ型骨折尺侧柱稳定性的有限元分析[J].中国组织工程研究,2020,24(30):4769-4774.
[5] RüEDI T P,BUCKLEY R E,MORAN C G.骨折治疗的AO原则[M].危杰,刘璠,吴新宝,等译. 2版.上海:上海科学技术出版社,2010:497-500.
[6] 蒋协远,王大伟.骨科临床疗效评价标准[M].北京:人民卫生出版社,2005:46.
[7] 余霄译,俞光荣.桡骨远端骨折的AAOS治疗指南[J].中国矫形外科杂志,2010,18(22):1887-1891.
[8] 王长军,孙永丽,于烨,等.手法复位联合夹板外固定治疗老年桡骨远端骨折的临床疗效观察[J].中国骨与关节损伤杂志,2021,36(1):95-96.
[9] 姜志洲,郑润杰,万爱雪.掌压复位结合压力垫夹板固定治疗新鲜闭合性桡骨远端屈曲型骨折[J].中医正骨,2020,32(6):62-64.
[10] 明文义,戴海东,陈林,等.手法整复杉树皮夹板外固定结合中药治疗桡骨远端骨折80例[J].浙江中医杂志,2019,54(9):658-659.
[11] 金剑飞,金威宏.小夹板固定治疗骨质疏松型桡骨远端骨折效果[J].光明中医,2020,35(8):1159-1161.
[12] 赖汝洽,杨洁,彭翔.钢板内固定与小夹板外固定治疗桡骨远端关节内骨折的效果比较[J].临床医学工程,2018,25(12):1623-1624.
[13] 吕建敏,林小勇,林加豪.成人桡骨远端骨折保守治疗后桡骨短缩的危险因素[J].中国骨伤,2017,30(6):513-517.
[14] 张妙林,高志朝,郑国富,等.桡骨远端骨折闭合复位后再移位相关危险因素分析[J].中国骨与关节损伤杂志,2019,34(3):262-265.
[15] 王亦璁.骨与关节损伤[M].4版.北京:人民卫生出版社,2007:16.
[16] 刘志昂,张陆,刘军,等.手法复位小夹板固定和切开复位内固定治疗骨质疏松型桡骨远端骨折的优劣差异[J].实用中西医结合临床,2018,18(10):131-132.
[17] 欧梁,卢敏,张永辉,等.手法复位小夹板固定治疗老年桡骨远端骨折临床疗效Meta分析[J].中国中西医结合杂志,2019,39(1):57-62.
[18] 韦欢,黄福才,杨群有.桡骨远端骨折高分子石膏夹板与小夹板固定疗效对比[J].实用中西医结合临床,2018,18(6):130-131.
[19] 李斌.对比分析小夹板外固定与石膏外固定治疗桡骨远端骨折的临床价值[J].中国伤残医学,2020,28(6):41-42.
[20] 颜威,蒋涛,吴昌桂,等.桡骨远端骨折固定夹板外观、材质、固定带等研究的新进展[J].中国组织工程研究,2020,24(9):1430-1434.
[21] CHEN Y J,LIN H,ZHANG X,et al.Application of 3D-printed and patient-specific cast for the treatment of distal radius fractures:initial experience[J].3D Print Med,2017,3(1):11.
[22] 王东强,江继中,张会涛,等.BOA系带系统小夹板固定治疗新鲜闭合性桡骨远端伸直型骨折[J].中医正骨,2019,31(9):61-63.

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　JIANG Tao,JIANG Lin,SHI Junde,et al.Application of Dongqi acupuncture(动气针法)to postoperative rehabilitation in the middle-late period in patients with ankle joint fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(05):20.
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备注/Memo

备注/Memo:
基金项目:苏州市科技发展计划项目(SS201877,SYSD2018192)
通讯作者:张志刚 E-mail:87061135@qq.com
更新日期/Last Update: 1900-01-01