手法整复硬纸夹板外固定治疗前臂双骨折  

Treatment of forearm double fracture with manipulative reduction and hard paper splints

作　　者：郝博川 鲍树仁 

机构地区：[1]丰盛中医骨伤专科医院,北京100140

出　　处：《中国骨伤》2011年第10期845-848,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨骨科手法外固定治疗前臂双骨折疗效及并发症。方法:2005年11月至2010年12月,采用骨科手法硬纸夹板外固定治疗前臂双骨折38例,其中男26例,女12例;年龄18～66岁,平均28岁。损伤至手法整复硬纸夹板外固定时间20min～2d,平均8h。施术前患肢肿胀、疼痛、畸形、异常活动,肘、腕屈伸功能及前臂旋转功能障碍,X线片显示均为前臂尺桡双骨折。术后通过对骨折的愈合情况、肘腕的屈伸功能及前臂的旋转功能进行疗效评定。结果:所有患者获得随访,时间3～8个月,平均5.7个月。根据Anderson前臂骨折治疗效果评价分级,优33例,骨折愈合,肘或腕关节的屈伸活动范围丢失<10%以及前臂旋转丢失<25%;良5例,骨折愈合,肘或腕关节的屈伸活动范围丢失<20%以及前臂旋转丢失<50%。结论:采用骨科手法外固定治疗前臂双骨折固定牢固且不会出现组织压疮及坏死,安全有效,值得临床推广。Objective：To explore the therapeutic effects and complications of manipulative reduction and hard paper splints in treating forearm double fracture.Methods：From November 2005 to December 2010,38 patients with forearm double fracture were treated with manipulative reduction and hard paper splints immobilization,including 26 males and 12 females,aged from 18 to 66 years（averaged 28 years）.The time from injury to manipulation was 20 min to 2 d with an average of 8 hours.Before treatment,the patients manifested swelling,pain,deformity,abnormal activity of injured limbs,dysfunction of elbow and wrist extension-flexion and forearm supination-pronation;X-rays showed fractures occurred in radius and ulna.Fracture healing,flexion function of elbow and wrist,supination-pronation function of forearm were used to evaluated the therapeutic effects.Results：All the patients were followed up,and the duration ranged from 3 to 8 months,with a mean of 5.7 months.According to Anderson grade criterion of forearm fractures,33 cases were excellent and fracture healing,which loss of elbow or wrist flexion and extension ranging 10% and forearm rotation 25%;5 cases were good and fracture healing,which loss of elbow or wrist flexion and extension ranging 20% and forearm rotation loss 50%;there was no dissatisfactory or failure cases.Conclusion：This method makes the fixation firmly,safely and utility,prevents the sore of pressing and necrosis,and worths further clinical applications.

关 键 词：前臂 骨折 手法 骨科 夹板 骨折固定术 外 

分 类 号：R683.410.5[医药卫生—骨科学]