手法整复尺桡骨干双骨折的临床体会  

Clinical experience about manipulative reduction of the radialis and ulnar fractures

作　　者：朱锦忠 肖智青 王爱明 

机构地区：[1]河源市中医院骨科,广东河源517000

出　　处：《中国骨伤》2010年第11期874-876,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:观察手法整复治疗尺桡骨干双骨折的临床疗效。方法:自2005年6月至2009年6月,采用手法整复、小夹板外固定治疗尺桡骨干双骨折85例,男50例,女35例;年龄1～20岁,平均10.8岁。直接暴力53例,传导暴力30例,扭转暴力2例;粉碎性骨折6例,螺旋形骨折8例,斜形骨折21例,横形或锯齿状骨折50例。按Anderson评价标准对临床效果进行评定。结果:85例患者中解剖复位42例,近解剖复位35例,8例再移位(经重新手法整复固定,2例达解剖复位,4例近解剖复位;2例整复不成功改行切开复位内固定术)。所有病例均临床愈合,愈合时间28～80d,平均42d。85例患者均获得随访,时间3～10个月,平均7.5个月。按Anderson评价标准,优77例,良5例,可3例。结论:手法整复夹板固定治疗尺桡骨干双骨折具有创伤小,固定牢靠,愈合迅速,费用低廉,临床疗效显著的特点。Objective：To observe the clinical efficacy about manipulative reduction of the radialis and ulnar fractures. Methods：From June 2005 to June 2009,85 patients with radialis and ulnar fractures,50 males and 35 females,ranging in age from 1 to 20 years with an average of 10.8 years,were treated with manipulative reduction and external fixation by small splint. There were 53 cases of direct violence,30 cases of transmission violence,2 cases of reversing violence;and there were 6 cases of comminuted fracture,8 cases of spiral fracture,21 cases of oblique fracture,50 cases of serrated or transverse fracture. The clinical effects were analyzed according to Anderson criterion. Results：Forty two cases obtained anatomical reduction and 35 cases obtained nearly anatomical reduction and 8 cases occurred re displacement. Eight cases of re displacement were re fixed after manipulative reduction,2 cases obtained anatomical reduction and 4 cases obtained nearly anatomical reduction; 2 cases unsuccessfully were diverted to open reduction and internal fixation. All the fractures obtained clinically healing with average of 42 days （ranged from 28 to 80 days）. All patients were followed up from 3 to 10 months with an average of 7.5 months. Ac- cording to Anderson criterion,77 case got excellent result,5 good,3 fair. Conclusion：Manipulation and external fixation by small splint for the treatment of radialis and ulnar fractures,have advantage of less trauma,forceful fixation,quick healing, cheap cost,which can obtain satisfactorily clinical effects.

关 键 词：尺骨骨折 桡骨骨折 正骨手法 小夹板固定 

分 类 号：R683.410.5[医药卫生—骨科学]