| 手法复位加小夹板钢托外固定治疗桡骨远端骨折 |
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投稿时间：2018-02-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 徐善强 |
XU Shan-qiang |
四川省骨科医院足踝2科, 四川 成都 610041 |
The 2nd Department of Foot and Ankle, Sichuan Provincial Orthopaedics Hospital, Sichuan 610041, Chengdu, China |
xushanqiang2008@163.com |
| 张宇 |
ZHANG Yu |
四川省骨科医院足踝2科, 四川 成都 610041 |
The 2nd Department of Foot and Ankle, Sichuan Provincial Orthopaedics Hospital, Sichuan 610041, Chengdu, China |
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| 张文举 |
ZHANG Wen-ju |
四川省骨科医院足踝2科, 四川 成都 610041 |
The 2nd Department of Foot and Ankle, Sichuan Provincial Orthopaedics Hospital, Sichuan 610041, Chengdu, China |
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| 李平 |
LI Ping |
四川省骨科医院足踝2科, 四川 成都 610041 |
The 2nd Department of Foot and Ankle, Sichuan Provincial Orthopaedics Hospital, Sichuan 610041, Chengdu, China |
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| 期刊信息：《中国骨伤》2018年，第31卷，第5期，第436-440页 |
| DOI：10.3969/j.issn.1003-0034.2018.05.008 |
| 基金项目:2015年度四川省骨科医院科研基金（编号：2015-31） |
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中文摘要:
目的：评价手法复位结合小夹板外固定治疗桡骨远端骨折的近期临床疗效。
方法：2015年1月至2016年12月，采用手法复位并行小夹板钢托外固定治疗桡骨远端骨折患者60例，男39例，女21例；年龄18~65（43.50±10.56）岁；按AO分型，A型38例，B型19例，C型3例。骨折复位前及复位后1、2、4周及拆除小夹板钢托时行腕关节正侧位X线检查，并测量其患侧掌倾角、尺偏角、桡骨高度。骨折复位后8、24、48周测量患侧腕关节背伸、掌屈、旋前、旋后、尺偏、桡偏活动度，骨折复位后、复位后4、8、24、48周测量健侧和患侧腕关节握力。桡骨远端骨折达到临床愈合后拆除小夹板钢托，拆除小夹板钢托后进行腕关节Mayo评分。
结果：60例桡骨远端骨折患者全部完成随访，骨折愈合时间6~8（7.1±0.9）周。掌倾角、尺偏角、桡骨短缩距离，复位前与复位后2周时比较，差异有统计学意义；复位后2周与4周比较，差异无统计学意义。复位后24周和8周，48周与24周时腕关节背伸、掌屈、旋前、旋后、尺偏、桡偏活动度比较，差异有统计学意义。患者复位后与复位后4周，复位后8周与4周，复位后16周与8周，复位后24周与16周时握力比较，差异有统计意义；复位后48周与24周时握力评分比较，差异无统计学意义。采用Mayo腕关节功能评分系统评价疗效，优50例，良8例，可1例，差1例。
结论：手法复位加小夹板钢托外固定治疗桡骨远端骨折，操作简单，临床疗效确切。 |
| 【关键词】桡骨骨折 腕损伤 骨折闭合复位 正骨手法 |
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| Treatment of distal radius fracture with manual reduction and external fixation with small splint steel support external fixation |
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ABSTRACT
Objective: To evaluate the short-term result for the treatment of distal radius fracture with manual resetting and fixing with small splint.
Methods: From January 2015 to December 2016, 60 cases of distal radial fractures were treated by manual resetting and small splint fixation including 39 males and 21 females with an average age of (43.50±10.56) years old ranging from 18 to 65 years old. According to AO classification, 38 cases were type A, 19 cases were type B, 3 cases were type C. The anteroposterior and lateral X-ray of the wrist joint was performed before reduction, 1, 2, 4 weeks after reduction, and the removal of the small splint, the palm inclination angle, ulnar deviation angle and radius height were measured. At 8, 24 and 48 weeks after reduction, the wrist extensor, palmar flexion, pronation, supination, ulnar deviation and radial deviation were measured. Wrist strength was measured at 4, 8, 24 and 48 weeks after fracture reduction. After the distal radius fracture healed, the splint support was removed. After dismantling small splint steel support, Mayo score of wrist joint was performed.
Results: All cases of distal radius fractures were followed up, the healing time of fracture was 6 to 8 (7.1±0.9) weeks. The difference of palmar obliquity, ulnar deviation angle and radius shortening between before reduction and 2 weeks after reduction was statistically significant. There was no significant difference in palmar inclination, ulnar deviation and radius shortening between 2 and 4 weeks after reduction. After 24 weeks and 8 weeks, 48 weeks and 24 weeks after reduction, there was significant difference in wrist extensor, palmar flexion, pronation, supination, ulnar deviation and radial deviation. The grip strength was statistically significant between after reduction and 4 weeks after reduction, 8 weeks and 4 weeks after reduction, 16 weeks and 8 weeks after reduction, 24 and 16 weeks after reduction. There was no significant difference in grip strength between 48 weeks and 24 weeks after reduction. The Mayo wrist function scoring system was used to evaluate the curative effect, the results were excellent in 50 cases, good in 8 cases, fair in 1 case and poor in 1 case.
Conclusion: The treatment of distal radius fracture with the method of manual resetting and fixing with plywood is simple and the clinical efficacy is accurate. |
| KEY WORDS Radius fractures Wrist injuries Closed fracture reduction Bone setting manipulation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 徐善强,张宇,张文举,李平.手法复位加小夹板钢托外固定治疗桡骨远端骨折[J].中国骨伤,2018,31(5):436~440 |
| 英文格式: | XU Shan-qiang,ZHANG Yu,ZHANG Wen-ju,LI Ping.Treatment of distal radius fracture with manual reduction and external fixation with small splint steel support external fixation[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(5):436~440 |
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