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[1]鄭軍,辛宗山,操儒道,等.小夾板外固定對不同類型Colles骨折固定效果的對比研究[J].中醫(yī)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.
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小夾板外固定對不同類型Colles骨折固定效果的對比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年04期
頁碼:
25-28,32
欄目:
臨床研究
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:
鄭軍辛宗山操儒道毛豐馬維初
湖北省鐘祥市人民醫(yī)院,湖北 鐘祥 431900
Author(s):
ZHENG JunXIN ZongshanCAO RudaoMAO FengMA Weichu
The People's Hospital of Zhongxiang City,Zhongxiang 431900,Hubei,China
關鍵詞:
小夾板固定 Colles骨折 橈骨骨折 臨床試驗
Keywords:
small splint fixation Colles' fracture radius fractures clinical trial
摘要:
目的:比較小夾板外固定對3種類型Colles骨折的固定效果。方法:回顧性分析62例采用手法復位小夾板外固定治療的Colles骨折患者的病例資料; 按AO分型標準,A型9例(A型組)、B型28例(B型組)、C型25例(C型組)。所有患者均按照《中醫(yī)骨傷科常見病診療指南》中橈骨遠端骨折的操作規(guī)范進行手法復位小夾板外固定。根據(jù)X線片評估骨折愈合情況,測量橈骨高度、掌傾角及尺偏角,并采用Green and O'Brien腕關節(jié)評分標準評定腕關節(jié)功能。比較治療后6周時3組患者的橈骨高度、掌傾角、尺偏角的恢復情況及治療后12個月時的腕關節(jié)功能。結果:所有患者均未發(fā)生骨折再移位。所有骨折均獲骨性愈合; 3組患者的骨折愈合時間比較,差異無統(tǒng)計學意義[(5.9±2.9)周,(6.1±2.4)周,(6.1±1.9)周,F=3.201,P=0.089]。治療后6周時,3組患者的掌傾角增加值比較,差異無統(tǒng)計學意義(12.64°±1.53°,14.08°±3.09°,14.03°±2.79°,F=2.166,P=0.121); 3組患者的橈骨高度增加值比較,差異有統(tǒng)計學意義[(0.97±0.17)cm,(0.83±0.19)cm,(0.63±0.16)cm,F=9.473,P=0.021],A型組橈骨高度增加值大于B型組和C型組(P=0.030; P=0.002),B型組大于C型組(P=0.001); 3組患者的尺偏角增加值比較,差異有統(tǒng)計學意義(15.60°±1.75°,16.57°±1.86°,13.76°±1.94°,F=11.483,P=0.001),A型組和B型組尺偏角增加值均大于C型組(P=0.001; P=0.029),A型組和B型組比較,差異無統(tǒng)計學意義(P=0.078)。治療后12個月時3組患者的Green and O'Brien評分比較,差異有統(tǒng)計學意義[(88.56±2.19)分,(81.79±4.74)分,(69.68±6.01)分,F=13.619,P=0.000],A型組的評分高于B型組和C型組(P=0.011; P=0.000),B型組評分高于C型組(P=0.001)。結論:對于A、B型Colles骨折,小夾板外固定可有效維持復位后骨折端的穩(wěn)定,有利于關節(jié)功能恢復; 但對于C型Colles骨折,小夾板外固定效果較差。
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.

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通訊作者:辛宗山 E-mail:[email protected]
更新日期/Last Update: 2016-08-30