外固定架固定结合康复锻炼治疗桡骨远端骨折的疗效分析  

Effect of external fixator combined with rehabilitation exercise in treatment of distal radius fractures

作　　者：李凡[1] 杨晶[1] 张鹰[1] 凯赛尔江.艾合买提 刘大鹏[1] LI Fan;YANG Jing;ZHANG Ying;Kesselyan Akomat;LIU Da-peng(Department of Orthopaedics, the Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830000, Chin)

机构地区：[1]新疆医科大学第五附属医院骨二科,新疆乌鲁木齐830000

出　　处：《中国骨与关节损伤杂志》2017年第11期1155-1157,共3页Chinese Journal of Bone and Joint Injury

基　　金：新疆维吾尔自治区自然科学基金(2016D01C238)

摘　　要：目的探讨外固定架固定结合康复锻炼治疗桡骨远端骨折的临床疗效。方法回顾性分析自2013-03—2016-02采用外固定架固定治疗的22例桡骨远端骨折,依从性良好能系统康复锻炼的12例纳入观察组,未进行康复锻炼的10例纳入对照组。比较2组末次随访时疼痛NRS评分、PRWE评分、腕关节功能Gartland-Werley评分,以及腕关节主动活动范围。结果观察组获得平均11.58(7~16)个月随访,对照组获得平均12.10(7~17)个月随访。末次随访时观察组疼痛NRS评分为(2.25±1.48)分,对照组为(3.40±1.78)分,2组差异无统计学意义(P>0.05)。末次随访时观察组腕关节主动活动范围均优于对照组,差异有统计学意义(P<0.05)。末次随访时观察组PRWE评分中总分、疼痛、功能均低于对照组,差异有统计学意义(P<0.05)。观察组Gartland-Werley评分中主观评价、客观评价均低于对照组,差异有统计学意义(P<0.05);但2组残余畸形、并发症评分差异无统计学意义(P>0.05)。结论采用外固定架固定治疗桡骨远端骨折可取得满意的手术效果,同时术后早期坚持规范康复锻炼可以提高患者腕关节功能,在一定程度上减轻或避免关节僵硬和挛缩。Objective To explore the clinical effect of external fixator fixation combined with rehabilitation exercise in the treatment of distal radius fractures. Methods Twenty-two patients with distal radius fractures who were treated with external fixator from March 2013 to February 2016 were enrolled in this study. Twelve patients who had good compliance with physical rehabilitation were included in the observation group and 10 patients without rehabilitation exercise were included in the control group. The NRS score, PRWE score, Gartland-Werley score, and wrist joint active range were compared between the two groups at the last follow-up. Results The observation group received an average of 11.58 （7-16） months follow-up while the control group received an average of 12.10（7-17）months follow-up. At the last follow-up, the NRS score was （2.25＋1.48） in the observation group and （3.40＋1.78） in the control group. There was no significant difference between the two groups （P 〉0.05）. At the last follow-up, the wrist joint active range of the observation group was better than that of the control group, the difference was statistically significant （P 〈0.05）. At the last follow-up, the total score, pain and function of the PRWE score in the observation group were lower than those in the control group, the difference was statistically significant（P 〈 0.05）. However, there were no significant differences in the residual malformations and complication scores of Gartland- Werley score between the two groups （P 〉0.05）. The difference was statistically significant in subjective evaluation and objective evaluation between the two groups （P 〈0.05）. Conclusion The external fixator for the treatment of distal radius fractures can achieve satisfactory surgical results, while early adherence to standard rehabilitation exercise can improve the patient＇s wrist function, to a certain extent, reduce or avoid joint stiffness and contracture.

关 键 词：桡骨远端骨折 外固定架 康复锻炼 

分 类 号：R687.3[医药卫生—骨科学]