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[1]段星星,馬奇翰,高鋒,等.紙夾板聯(lián)合木夾板固定治療閉合性橈骨遠(yuǎn)端骨折的臨床研究[J].中醫(yī)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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紙夾板聯(lián)合木夾板固定治療閉合性橈骨遠(yuǎn)端骨折的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期數(shù):
2021年05期
頁(yè)碼:
24-27
欄目:
臨床研究
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; 馬奇翰; 高鋒; 李宇衛(wèi); 張志剛
(蘇州市中醫(yī)醫(yī)院,江蘇 蘇州 215009)
Author(s):
DUAN Xingxing; MA Qihan; GAO Feng; LI Yuwei; ZHANG Zhigang
Suzhou Hospital of Traditional Chinese Medicine,Suzhou 215009,Jiangsu,China
關(guān)鍵詞:
橈骨骨折;  骨折; 閉合性;  Colles骨折;  小夾板固定;  石膏; 外科;  臨床試驗(yàn)
Keywords:
radius fractures;  fractures; closed;  Colles’fracture;  small splint fixation;  casts; surgical;  clinical trial
摘要:
目的:觀察紙夾板聯(lián)合木夾板固定治療閉合性橈骨遠(yuǎn)端骨折的臨床療效。方法:將符合要求的60例閉合性橈骨遠(yuǎn)端骨折患者隨機(jī)分為2組,每組30例。手法復(fù)位后,聯(lián)合固定組采用紙夾板聯(lián)合木夾板固定,石膏固定組采用管形石膏固定。測(cè)量患側(cè)橈骨高度、掌傾角、尺偏角,記錄骨折愈合時(shí)間,采用疼痛視覺(jué)模擬量表(visual analogue scale,VAS)評(píng)分評(píng)價(jià)腕部疼痛程度,采用改良Green和O’Brien腕關(guān)節(jié)評(píng)分標(biāo)準(zhǔn)評(píng)價(jià)綜合療效。結(jié)果:治療前2組患者腕部疼痛VAS評(píng)分比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(8.31±1.24)分,(8.27±1.41)分,t=1.415,P=0.257]; 治療結(jié)束后7 d,聯(lián)合固定組患者腕部疼痛VAS評(píng)分低于石膏固定組[(2.54±0.53)分,(4.27±0.42)分,t=6.132,P=0.018]。所有患者均獲隨訪,隨訪時(shí)間3～12個(gè)月,中位數(shù)5個(gè)月。骨折均愈合,聯(lián)合固定組的骨折愈合時(shí)間短于石膏固定組[(59.58±4.74)d,(70.73±6.37)d,t=8.555,P=0.021]。治療結(jié)束后3個(gè)月,聯(lián)合固定組的患側(cè)橈骨高度高于石膏固定組、掌傾角及尺偏角均大于石膏固定組[(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]; 綜合療效評(píng)價(jià),聯(lián)合固定組優(yōu)14例、良12例、可4例,石膏固定組優(yōu)6例、良15例、可8例、差1例,聯(lián)合固定組的綜合療效優(yōu)于石膏固定組(Z=-2.322,P=0.020)。結(jié)論:紙夾板聯(lián)合木夾板固定治療閉合性橈骨遠(yuǎn)端骨折,可以減輕腕部疼痛、糾正腕部畸形、促進(jìn)骨折愈合,療效優(yōu)于管形石膏固定治療。
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.

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備注/Memo

備注/Memo:
基金項(xiàng)目:蘇州市科技發(fā)展計(jì)劃項(xiàng)目(SS201877,SYSD2018192)
通訊作者:張志剛 E-mail:[email protected]
更新日期/Last Update: 1900-01-01