[1]郑军,辛宗山,操儒道,等.小夹板外固定对不同类型Colles骨折固定效果的对比研究[J].中医正骨,2016,28(04):25-28，32.
　ZHENG Jun,XIN Zongshan,CAO Rudao,et al.Comparative study on the fixation effects of small splint external fixation in treatment of different types of Colles fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(04):25-28，32.
点击复制

小夹板外固定对不同类型Colles骨折固定效果的对比研究()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年04期
页码:
25-28，32
栏目:
临床研究
出版日期:
2016-04-20

文章信息/Info

Title:
Comparative study on the fixation effects of small splint external fixation in treatment of different types of Colles fractures
作者:
郑军; 辛宗山; 操儒道; 毛丰; 马维初
湖北省钟祥市人民医院,湖北 钟祥 431900
Author(s):
ZHENG Jun; XIN Zongshan; CAO Rudao; MAO Feng; MA Weichu
The People's Hospital of Zhongxiang City,Zhongxiang 431900,Hubei,China
关键词:
小夹板固定;  Colles骨折;  桡骨骨折;  临床试验
Keywords:
small splint fixation;  Colles' fracture;  radius fractures;  clinical trial
摘要:
目的:比较小夹板外固定对3种类型Colles骨折的固定效果。方法:回顾性分析62例采用手法复位小夹板外固定治疗的Colles骨折患者的病例资料; 按AO分型标准,A型9例(A型组)、B型28例(B型组)、C型25例(C型组)。所有患者均按照《中医骨伤科常见病诊疗指南》中桡骨远端骨折的操作规范进行手法复位小夹板外固定。根据X线片评估骨折愈合情况,测量桡骨高度、掌倾角及尺偏角,并采用Green and O'Brien腕关节评分标准评定腕关节功能。比较治疗后6周时3组患者的桡骨高度、掌倾角、尺偏角的恢复情况及治疗后12个月时的腕关节功能。结果:所有患者均未发生骨折再移位。所有骨折均获骨性愈合; 3组患者的骨折愈合时间比较,差异无统计学意义[(5.9±2.9)周,(6.1±2.4)周,(6.1±1.9)周,F=3.201,P=0.089]。治疗后6周时,3组患者的掌倾角增加值比较,差异无统计学意义(12.64°±1.53°,14.08°±3.09°,14.03°±2.79°,F=2.166,P=0.121); 3组患者的桡骨高度增加值比较,差异有统计学意义[(0.97±0.17)cm,(0.83±0.19)cm,(0.63±0.16)cm,F=9.473,P=0.021],A型组桡骨高度增加值大于B型组和C型组(P=0.030; P=0.002),B型组大于C型组(P=0.001); 3组患者的尺偏角增加值比较,差异有统计学意义(15.60°±1.75°,16.57°±1.86°,13.76°±1.94°,F=11.483,P=0.001),A型组和B型组尺偏角增加值均大于C型组(P=0.001; P=0.029),A型组和B型组比较,差异无统计学意义(P=0.078)。治疗后12个月时3组患者的Green and O'Brien评分比较,差异有统计学意义[(88.56±2.19)分,(81.79±4.74)分,(69.68±6.01)分,F=13.619,P=0.000],A型组的评分高于B型组和C型组(P=0.011; P=0.000),B型组评分高于C型组(P=0.001)。结论:对于A、B型Colles骨折,小夹板外固定可有效维持复位后骨折端的稳定,有利于关节功能恢复; 但对于C型Colles骨折,小夹板外固定效果较差。
Abstract:
Objective:To compare the fixation effects of small splint external fixation for treatment of three types of Colles fractures.Methods:The medical records of 62 patients with Colles fractures who were treated with manipulative reduction and small splint external fixation were analyzed retrospectively.The fractures belonged to AO types A(9),B(28)and C(25).Manipulative reduction and small splint external fixation were performed on all of the patients according to the operation specification of distal radius fracture which was extracted from Guidelines For Diagnosis And Treatment Of Commom Diseases Of Orthopedics And Traumatology In Traditional Chinese Medicine.Fracture healing were evaluated and radial heights,volar tilt angles and radial inclination angles were measured according to the X-ray films.In addition,the wrist joints function were evaluated by using Green and O'Brien wrist joint scoring criterion.The recovery of radial heights,volar tilt angles and radial inclination angles were compared between the 3 groups at 6 weeks after the treatment and the wrist joints function were compared between the 3 groups at 12 months after the treatment.Results:No fracture re-displacement was found.All the patients got bone union and there was no statistical difference in the fracture healing time between the 3 groups(5.9+/-2.9,6.1+/-2.4,6.1+/-1.9 weeks,F=3.201,P=0.089).There was no statistical difference in the increase values of volar tilt angles between the 3 groups(12.64+/-1.53,14.08+/-3.09,14.03+/-2.79 degrees,F=2.166,P=0.121)and there was statistical difference in the increase values of radial heights between the 3 groups at 6 weeks after the treatment(0.97+/-0.17,0.83+/-0.19,0.63+/-0.16 cm,F=9.473,P=0.021).The increase values of radial heights were greater in type A group compared to type B group and type C group(P=0.030; P=0.002),and were greater in type B group compared to type C group(P=0.001).There was statistical difference in the increase values of radial inclination angles between the 3 groups(15.60+/-1.75,16.57+/-1.86,13.76+/-1.94 degrees,F=11.483,P= 0.001).The increase values of radial inclination angles were greater in type A group and type B group compared to type C group(P=0.001; P=0.029),and there was no statistical difference between type A group and type B group(P=0.078).There was statistical difference in Green and O'Brien scores between the 3 groups at 12 months after the treatment(88.56+/-2.19,81.79+/-4.74,69.68+/-6.01 points,F=13.619,P=0.000).The scores were higher in type A group compared to type B group and type C group(P=0.011; P=0.000),and the scores were higher in type B group compared to type C group(P=0.001).Conclusion:For treatment of type A and B Colles fractures,small splint external fixation can effectively maintain the stabilization of broken ends of fractured bone after reduction,and benefits joint functional recovery.However,it has poor fixation effects on type C Colles fractures.

参考文献/References:

[1] 杨志全,李海生.两种手术方法治疗桡骨远端粉碎性骨折的临床效果[J].中国矫形外科杂志,2015,23(18):1719-1721.
[2] Kasapinova K,Kamiloski V.Open reduction and internal fixation versus external fixation and/or kirschner wires for distal radius fractures.A systematic review[J].Pril(Makedon Akad Nauk Umet Odd Med Nauki),2014,35(1):225-236.
[3] 张容超,徐卫国,万春友,等.手法整复小夹板固定治疗桡骨远端骨折168例[J].中医正骨,2015,27(11):61-64.
[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,2002:37-38.
[5] Green DP,O'Brien ET.Open reduction of carpal dislocations:indications and operative techniques[J].J Hand Surg Am,1978,3(3):250-265.
[6] 中华中医药学会.中医骨伤科常见病诊疗指南[M].北京:中国中医药出版社,2012:94-99.
[7] Lalone E A,Grewal R,King GJW,et al.A structured review addressing the use of radiographic measures of alignment and the definition of acceptability in patients with distal radius fractures[J].Hand(NY),2015,10(4):621-638.
[8] 黄晓楠.老年桡骨远端AO C型骨折修复:闭合复位外固定支架的生物学优势[J].中国组织工程研究,2015,19(35):5684-5690.
[9] Padegimas EM,Ilyas AM.Distal radius fractures emergency department evaluation and management[J].Orthopedic Clinics of North America,2015,46(2):259.
[10] 王兴凯,杨付晋,苏晓龙.手法整复小夹板外固定治疗桡骨远端骨折的临床观察[J].中国骨伤,2010,23(8):573-574.
[11] 彭利平,辜志昌,何庆建.折顶挤扣法配合中药外用治疗老年桡骨远端骨折[J].中国骨伤,2010,23(8):569-570.
[12] 刘欣,刘文刚,吴淮,等.3种方法治疗C型桡骨远端骨折的对比研究[J].中医正骨,2015,27(5):12-16.
[13] 刘光明,陈建华.Colles骨折的非手术疗法研究进展[J].中医正骨,2011,23(12):66-68.
[14] Kumbaraci M,Kucuk L,Karapinar L,et al.Retrospective comparison of external fixation versus volar locking plate in the treatment of unstable intra-articular distal radius fractures[J].Eur J Orthop Surg Traumatol,2014,24(2):173-178.
[15] Brogan DM,Richard MJ,Ruch D,et al.Management of severely comminuted distal radius fractures[J].J Hand Surg Am,2015,40(9):1905-1914.
[16] 吴良金,柴君雷.手法整复杉树皮夹板外固定结合中药治疗老年桡骨远端骨折[J].中医正骨,2014,26(11):57-58.
[17] 贾浙西.手法整复夹板外固定治疗桡骨远端伸直型粉碎性骨折68例[J].中医正骨,2010,22(6):59-60.

相似文献/References:

[1]祁峰,肖鲁伟.小夹板的应用前景[J].中医正骨,2011,23(09):33.
[2]聂伟志,隋显玉.牵屈复位半管形石膏固定治疗老年Colles骨折[J].中医正骨,2016,28(03):50.
[3]桂光明,曹波,张惠,等.石膏托和小夹板外固定对Colles骨折复位后短期位置丢失的影响[J].中医正骨,2016,28(04):19.
　GUI Guangming,CAO Bo,ZHANG Hui,et al.Effect of plaster slab external fixation and small splint external fixation on short-term position loss after reduction of Colles fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(04):19.
[4]霍乐乐,周中华,樊立波,等.闭合复位经皮穿针固定联合微创植骨治疗桡骨远端骨折[J].中医正骨,2017,29(02):65.
[5]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.
　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(04):24.
[6]陈延荣,孙长虹,梁学振,等.健康成人前臂小夹板固定时压垫对腕关节局部压力的影响[J].中医正骨,2022,34(10):27.
　CHEN Yanrong,SUN Changhong,LIANG Xuezhen,et al.Effects of pressure pad on local wrist pressure when fixing forearm with small splints in healthy adults[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(04):27.

备注/Memo

备注/Memo:
通讯作者:辛宗山 E-mail:xinhongcha@sina.com
更新日期/Last Update: 2016-08-30