84年鼠女哪年财运最旺,857comvvv色九欧美激情|85PO_87国产精品欲av国产av资源

[1]郭世明,石玲玲,郭志民,等.手法復(fù)位石膏外固定和切開(kāi)復(fù)位鋼板內(nèi)固定治療 骨質(zhì)疏松性橈骨遠(yuǎn)端骨折的比較研究[J].中醫(yī)正骨,2015,27(04):15-20.
　GUO Shiming,SHI Lingling,GUO Zhimin,et al.A comparative study of manual reduction and plaster external fixation versus open reduction and plate internal fixation for treatment of osteoporotic distal radius fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(04):15-20.
點(diǎn)擊復(fù)制

手法復(fù)位石膏外固定和切開(kāi)復(fù)位鋼板內(nèi)固定治療 骨質(zhì)疏松性橈骨遠(yuǎn)端骨折的比較研究()
分享到：

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期數(shù):
2015年04期
頁(yè)碼:
15-20
欄目:
臨床研究
出版日期:
2015-04-30

文章信息/Info

Title:
A comparative study of manual reduction and plaster external fixation versus open reduction and plate internal fixation for treatment of osteoporotic distal radius fractures
作者:
郭世明1; 石玲玲2; 郭志民2; 林燕萍3
1.福建中醫(yī)藥大學(xué),福建 福州 350100;
2.中國(guó)人民解放軍第175醫(yī)院, 福建 漳州 363000;
3.福建中醫(yī)藥大學(xué)中西醫(yī)結(jié)合研究院,福建 福州 350100
Author(s):
GUO Shiming1; SHI Lingling2; GUO Zhimin2; LIN Yanping3
1.Fujian University of Traditional Chinese Medicine,Fuzhou 350100,Fujian,China
2.The 175th Hospital of PLA,Zhangzhou 363000,Fujian,China
3.Academy of Integrative Medicine affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350100,Fujian,China
關(guān)鍵詞:
橈骨骨折;  骨質(zhì)疏松性骨折;  正骨手法;  石膏; 外科;  骨折固定術(shù); 內(nèi);  內(nèi)固定器;  治療; 臨床研究性
Keywords:
radius fractures;  osteoporotic fractures;  bone setting manipulation;  casts; surgical;  fracture fixation; internal;  internal fixators;  therapies; investigational
摘要:
目的:比較手法復(fù)位石膏外固定和切開(kāi)復(fù)位鋼板內(nèi)固定治療骨質(zhì)疏松性橈骨遠(yuǎn)端骨折的臨床療效和安全性。方法:回顧性分析73例骨質(zhì)疏松性橈骨遠(yuǎn)端骨折患者的病例資料,其中采用手法復(fù)位石膏外固定44例,采用切開(kāi)復(fù)位鋼板內(nèi)固定29例。男32例,女41例; 年齡60～79例,中位數(shù)69歲; 左側(cè)27例,右側(cè)46例; 按照橈骨遠(yuǎn)端骨折的AO分類,A3型18例、B2型8例、B3型12例、C1型19例、C2型16例。記錄并比較2組患者骨折愈合時(shí)間、掌傾角和尺偏角及并發(fā)癥發(fā)生情況。記錄并比較2組患者骨折愈合時(shí)及骨折愈合后6個(gè)月的前臂旋前角度、前臂旋后角度及Robbins腕關(guān)節(jié)評(píng)分。結(jié)果:手法復(fù)位石膏外固定組骨折愈合時(shí)間、掌傾角、尺偏角均小于切開(kāi)復(fù)位鋼板內(nèi)固定組[(9.75±1.04)周,(11.83±0.75)周,t=17.280,P=0.001; 9.88°±1.47°,12.43°±1.27°,t=10.509,P=0.007; 21.13°±0.85°,22.72°±0.66°,t=14.350,P=0.003]。骨折愈合時(shí)手法復(fù)位石膏外固定組前臂旋前、旋后角度及Robbins腕關(guān)節(jié)評(píng)分均低于切開(kāi)復(fù)位鋼板內(nèi)固定組[25.63°±6.72°,51.17°±8.93°,t=37.555,P=0.000; 22.13°±4.58°,51.33°±5.72°,t=113.150,P=0.000;(3.88±0.64)分,(6.00±0.59)分,t=67.632,P=0.000]; 骨折愈合后6個(gè)月2組患者前臂旋前、旋后角度及Robbins腕關(guān)節(jié)評(píng)分比較,組間差異均無(wú)統(tǒng)計(jì)學(xué)意義[77.50°±6.74°,81.50°±4.60°,t=1.554,P=0.236; 73.63°±5.71°,73.50°±1.87°,t=0.003,P=0.960;(7.63±0.92)分,(8.00±1.06)分,t=1.479,P=0.236]。2組患者并發(fā)癥發(fā)生率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=0.052,P=0.820)。結(jié)論:對(duì)于骨質(zhì)疏松性橈骨遠(yuǎn)端骨折患者而言,在骨折復(fù)位以及骨折愈合時(shí)的腕關(guān)節(jié)活動(dòng)能力和功能方面,切開(kāi)復(fù)位鋼板內(nèi)固定優(yōu)于手法復(fù)位石膏外固定; 但手法復(fù)位石膏外固定的骨折愈合時(shí)間短,且骨折愈合后6個(gè)月的腕關(guān)節(jié)功能及安全性方面與切開(kāi)復(fù)位鋼板內(nèi)固定無(wú)明顯差異,符合老年患者的治療要求,可作為臨床治療骨質(zhì)疏松性橈骨遠(yuǎn)端骨折的一種較為理想的選擇。
Abstract:
Objective:To compare the clinical curative effect and safety of manual reduction and plaster external fixation versus open reduction and plate internal fixation in the treatment of osteoporotic distal radius fractures(ODRF).Methods:The medical records of 73 patients with ODRF were analyzed retrospectively.Forty-four patients were treated with manual reduction and plaster external fixation,while the others were treated with open reduction and plate internal fixation.The patients consisted of 32 males and 41 females,and ranged in age from 60 to 79 years(Median=69 yrs).The fractures located in left radius for 27 patients and right radius for 46 patients.According to the AO classification of distal radius fracture,the fractures belonged to types A3(18),B2(8),B3(12),C1(19)and C2(16).The fracture healing time,volar tilt angles,radial inclination angles and complications were recorded and compared between the 2 groups.The antebrachial pronation angles,antebrachial supination angles and Robbins wrist scores were also recorded and compared between the 2 groups when the fractures healed and at 6 months after the fracture healing.Results:Fracture healing time,volar tilt angles and radial inclination angles were less in manual reduction and plaster external fixation group compared to open reduction and plate internal fixation group(9.75+/-1.04 vs 11.83+/-0.75 weeks,t=17.280,P=0.001; 9.88+/-1.47 vs 12.43+/-1.27 degrees,t=10.509,P=0.007; 21.13+/-0.85 vs 22.72+/-0.66 degrees,t=14.350,P=0.003).Antebrachial pronation angles,antebrachial supination angles and Robbins wrist scores were less in manual reduction and plaster external fixation group compared to open reduction and plate internal fixation group when the fractures healed(25.63+/-6.72 vs 51.17+/-8.93 degrees,t=37.555,P=0.000; 22.13+/-4.58 vs 51.33+/-5.72 degrees,t=113.150,P=0.000; 3.88+/-0.64 vs 6.00+/-0.59 points,t=67.632,P=0.000).There was no statistical difference in antebrachial pronation angles,antebrachial supination angles and Robbins wrist scores between the 2 groups at 6 months after the fracture healing(77.50+/-6.74 vs 81.50+/-4.60 degrees,t=1.554,P=0.236; 73.63+/-5.71 vs 73.50+/-1.87 degrees,t=0.003,P=0.960; 7.63+/-0.92 vs 8.00+/-1.06 points,t=1.479,P=0.236).There was no statistical difference in complication incidences between the two groups(χ2=0.052,P=0.820).Conclusion:For patients with ODRF,open reduction and plate internal fixation surpasses manual reduction and plaster external fixation in fracture reduction,daily activity and function of wrist when the fracture healed.However,shorter fracture healing time can be obtained by using manual reduction and plaster external fixation,and there is no significant difference in wrist joint function and safety between the 2 therapies at 6 months after the fracture healing.Therefore,the therapy of manual reduction and plaster external fixation can meet the requirement for treatment of aged patients and can be used as an ideal therapy for treatment of ODRF in clinic.

參考文獻(xiàn)/References:

[1] Oyen J,Brudvik C,Gjesdal CG,et al.Osteoporosis as a risk factor for distal radial fractures:a case-control study[J].J Bone Joint Surg Am,2011,93(4):348-356.
[2] 穆光宗,張團(tuán).我國(guó)人口老齡化的發(fā)展趨勢(shì)及其戰(zhàn)略應(yīng)對(duì)[J].華中師范大學(xué)學(xué)報(bào):人文社會(huì)科學(xué)版,2011,50(5):29-36.
[3] Müller ME,Nazarian S,Koch P.Classification AO des fractures:LES os longs[M].Berlin:Springer Verlag,1987:198-201.
[4] 中華醫(yī)學(xué)會(huì)骨質(zhì)疏松和骨礦鹽疾病分會(huì).原發(fā)性骨質(zhì)疏松癥診治指南(2011年)[J].中華骨質(zhì)疏松和骨礦鹽疾病雜志,2011,4(1):2-15.
[5] Robbins RR,Ridge O,Carter PR.Iliac crest bone grafting and Herbert screw fixation of nonunions of the scaphoid with avascular proximal poles[J].J Hand Surg Am,1995,20(5):818-831.
[6] 胡慶豐,范順武,周輝,等.掌側(cè)T形鎖定加壓接骨板治療老年橈骨遠(yuǎn)端骨折[J].中國(guó)骨傷,2007,20(4):268-270.
[7] 金建強(qiáng),張駿,陸逸庭,等.解剖型橈骨遠(yuǎn)端掌側(cè)鎖定接骨板治療老年橈骨遠(yuǎn)端骨折[J].中醫(yī)正骨,2013,25(12):66-68.
[8] Wright TW,Horodyski M,Smith DW.Functional outcome of unstable distal radius fractures:ORIF with a volar fixed-angle tine plate versus external fixation[J].J Hand Surg Am,2005,30(2):289-299.
[9] 陳民,林學(xué)波,王寰,等.改進(jìn)夾板固定治療橈骨遠(yuǎn)端粉碎性骨折的臨床療效對(duì)比研究[J].中國(guó)骨傷,2008,21(2):87-89.
[10] Young BT,Rayan GM.Outcome following nonoperative treatment of displaced distal radius fractures in low-demand patients older than 60 years[J].J Hand Surg Am,2000,25(1):19-28.
[11] Arora R,Gabl M,Gschwentner M,et al.A comparative study of clinical and radiologic outcomes of unstable colles type distal radius fractures in patients older than 70 years:nonoperative treatment versus volar locking plating[J].J Orthop Trauma,2009,23(4):237-242.
[12] Mackenney PJ,Mcqueen MM,Elton R.Prediction of instability in distal radial fractures[J].J Bone Joint Surg Am,2006,88(9):1944-1951.
[13] Gofton W,Liew A.Distal radius fractures: nonoperative and percutaneous pinning treatment options[J].Orthop Clin North Am,2007,38(2):175-185.
[14] Wu GB,Dong KF,Xu XH,et al.Case-control studies on external fixator for the treatment of comminuted distal radius fractures in senile[J].Zhongguo Gu Shang,2009,22(9):678-680.
[15] 王曉光,于大鵬,慈曉杰.中藥洗劑配合手法治療老年橈骨遠(yuǎn)端骨折關(guān)節(jié)僵直[J].中醫(yī)正骨,2013,25(8):32.

相似文獻(xiàn)/References:

[1]許兵,葉小雨,王蕭楓,等.小管徑經(jīng)皮椎體后凸成形術(shù)治療 骨質(zhì)疏松性椎體重度壓縮骨折[J].中醫(yī)正骨,2015,27(11):29.
[2]張容超,徐衛(wèi)國(guó),萬(wàn)春友,等.手法整復(fù)小夾板固定治療橈骨遠(yuǎn)端骨折168例[J].中醫(yī)正骨,2015,27(11):61.
[3]徐善強(qiáng),陳星,張興平,等.功能鍛煉對(duì)橈骨遠(yuǎn)端骨折拆除石膏外固定后 腕關(guān)節(jié)康復(fù)的影響[J].中醫(yī)正骨,2015,27(10):58.
[4]趙萌,陳云豐,周祖忠.切開(kāi)復(fù)位T形鋼板聯(lián)合空心釘內(nèi)固定治療 MasonⅢ型橈骨頭骨折[J].中醫(yī)正骨,2015,27(07):58.
[5]劉昕,鄧志強(qiáng),葉家軍.撬撥復(fù)位彈性髓內(nèi)釘固定治療JudetⅣ型兒童橈骨頸骨折[J].中醫(yī)正骨,2015,27(12):65.
[6]劉欣,劉文剛,吳淮,等.3種方法治療C型橈骨遠(yuǎn)端骨折的對(duì)比研究[J].中醫(yī)正骨,2015,27(05):12.
　LIU Xin,LIU Wengang,WU Huai,et al.A comparative study of three methods for treatment of type C distal radius fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(04):12.
[7]謝小利,李曉程.經(jīng)皮椎體后凸成形術(shù)治療骨質(zhì)疏松性椎體 壓縮骨折的圍手術(shù)期護(hù)理[J].中醫(yī)正骨,2015,27(05):79.
[8]明曉鋒,陳登山,張曉強(qiáng).閉合復(fù)位彈性髓內(nèi)釘固定和經(jīng)皮克氏針撬撥復(fù)位固定 治療兒童O'BrienⅡ、Ⅲ型橈骨頸骨折的療效比較[J].中醫(yī)正骨,2016,28(02):15.
　MING Xiaofeng,CHEN Dengshan,ZHANG Xiaoqiang.A clinical comparison of closed reduction and internal fixation with elastic intramedullary nails versus percutaneous leverage reduction and internal fixation with Kirschner wire for treatment of O'Brien typeⅡandⅢradial neck fractures in children[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(04):15.
[9]王仲鋒,王曉,李國(guó)軍,等.骨折三維形態(tài)分型在MasonⅡ型橈骨頭骨折 Herbert螺釘內(nèi)固定術(shù)中的應(yīng)用[J].中醫(yī)正骨,2016,28(03):38.
[10]鄭移兵,鮑樹(shù)仁,齊越峰,等.推壓手法復(fù)位紙夾板外固定治療Smith骨折[J].中醫(yī)正骨,2016,28(03):45.

備注/Memo

備注/Memo:
2014-09-22收稿 2014-11-02修回
基金項(xiàng)目:國(guó)家自然科學(xué)基金項(xiàng)目(81173282)
更新日期/Last Update: 2015-04-30