颈肩腕托带与“8”字绷带治疗成人锁骨中段骨折疗效比较  

A comparative study of arm sling and 8-shaped bandage for middle-third clavicle fractures

作　　者：曾东杰 张远军[2] 郑臣校[2] 李绪松[2] Zeng Dongji;Zhang Yuanjun;Zheng Chenxiao;Li Xusong(Graduate School of Guangzhou University of Traditional Chinese Medicine, Guangzhou Guangdong 510006, China;Zhongshan Hospital of Traditional Chinese Medicine,Guangzhou University of Tradition Chinese Medicine, Zhongshan Guangdong 528400,China)

机构地区：[1]广州中医药大学研究生院,广东广州510006 [2]广州中医药大学附属中山市中医院,广东中山528400

出　　处：《遵义医学院学报》2017年第6期669-672,677,共5页Journal of Zunyi Medical University

基　　金：中山市卫生和计划生育局医学科研项目(NO:2017J072)

摘　　要：目的观察并比较颈肩腕托带与"8"字绷带治疗成人锁骨中段骨折的临床疗效。方法将72例符合纳入标准的成人锁骨中段骨折患者随机分为两组,颈肩腕托带组(36例)和"8"字绷带组(36例)。颈肩腕托带组采用手法复位及颈肩腕托带固定治疗,"8"字绷带组采用手法复位及"8"字绷带固定治疗,比较两组患者治疗后第1、7、14及30天的疼痛情况、患者满意度、并发症等指标,并在最后1周按CM和DASH评分的方法进行疗效评定。结果所有患者均获得随访,颈肩腕托带组随访11.75±1.38个月;"8"字绷带组随访12.06±1.33个月。两组患者随访时间差异无统计学意义(t=-0.956,P=0.342>0.05))。颈肩腕托带组和"8"字绷带组治疗后第1天的疼痛(VAS)评分有统计学意义(P=0.020<0.05),第7、14及30天两组疼痛(VAS)评分无统计学意义(P>0.05)。颈肩腕托带组33例患者满意,3例患者不满意,"8"字绷带组30例患者满意,6例患者不满意,两组差异无统计学意义(P>0.05)。颈肩腕托带组并发症情况,3例(8.3%)患者出现畸形愈合,2例(5.6%)出现不愈合;"8"字绷带组有3例(8.3%)畸形愈合,1例(2.7%)不愈合,两组差异没有统计学意义(P>0.05)。最后1周按CM和DASH肩关节评分,两组差异无统计学意义(P>0.05)。结论对于成人锁骨中段骨折,颈肩腕托带与"8"字绷带治疗均能获得良好的疗效,注意避免颈肩腕托带与"8"字绷带治疗带来的不良影响。而颈肩腕托带治疗具有疼痛程度较低、使用方便等特点,值得临床推广。Objective To compare the efficacy of8-shaped bandage with arm sling for middle-third clavicle fractures.Methods The included72patients with adult middle clavicle fracture were randomly divided into8-shaped bandage group and arm sling group.The arm sling group was treated with manipulative reduction and fixation with the arm sling.The8-shaped bandage group was treated with manipulative reduction and fixation with8-shaped bandage.Complete outcome measures including pain conditions(on day1,7,14and30),patients’satisfaction,complications and other indicators were compared.In the last week,the CM(constant-Murley)and Disabilities of the Arm,Shoulder and Hand(DASH)scores for efficacy were applied for efficacy evaluation.Results All patients were followed up.The arm sling group was followed up for11.75±1.38months and the8-shaped bandage12.06±1.33months.In terms of follow-up duration,there was no statistically significant difference between the two groups(t=-0.956,P=0.342>0.05).The difference of the pain scores between the arm sling support group and the8-shaped bandage group the next day(day1)was statistically significant(P<0.05).The pain scores of the two groups after day7,14,and30showed no statistically significant difference(P>0.05).3out of36patients in the arm sling group were dissatisfied while6out of36in the8-shapged bandage group were dissatisfied;there was no statistically significant difference between these two groups(P>0.05).In terms of complications,3cases(8.3%)of malunion and2cases(5.6%)of nonunion occurred in the arm sling support group;3cases(8.3%)of malunion and1case(2.7%)of nonunion appeared in the8-shaped bandage group;there was no statistically significant difference between these two groups(P>0.05).In the last week,CMS and DASH shoulder scores were used and found no statistically significant difference between these two groups(P>0.05).Conclusion Both treatments can produce good effects for adult middle-third clavicle fractures,but the side-effects should be avoided.Arm sling with less pain and more

关 键 词：锁骨中段骨折 保守治疗 颈肩腕托带 “8”字绷带 

分 类 号：R274.11[医药卫生—中医骨伤科学]