两种方法治疗桡骨远端骨骺骨折的临床疗效比较研究  

A Comparative Study of the Clinical Effects of Two Methods in Treating Children’s Distal Radial Epiphyseal Fractures

作　　者：陈元荣 江湧[1] 朱秋贤[1] 林耿明 邓再冲 洪石 CHEN Yuanrong;JIANG Yong;ZHU Qiuxian;LIN Gengming;DENG Zaichong;HONG Shi(Department of Orthopedics,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong China)

机构地区：[1]广东省佛山市中医院,广东佛山528000

出　　处：《中国中医骨伤科杂志》2020年第9期34-39,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:比较桡骨远端骨骺骨折闭合手法复位夹板外固定与闭合手法复位克氏针内固定的临床疗效差异。方法:回顾性分析2016年2月至2019年2月诊治的107例桡骨远端骨骺骨折患者,按治疗方法不同分为观察组和对照组,分别施行手法复位夹板外固定和手法复位克氏针内固定治疗。末次随访时基于掌倾角和尺偏角对骨折愈合及复位情况进行影像学评估,基于腕关节活动度、Gartland-Werley腕关节评分及家属满意度方面综合评估两组患者的临床疗效和并发症情况。结果:所有病例均获得12~32个月随访(平均18个月),均未发现骨不连、延迟愈合、桡骨远端骨骺早闭等并发症发生。两者在掌倾角、尺偏角、腕关节活动度、Gartland-Werley评分结果优良率方面,组间比较差异均无统计学意义(P>0.05)。但并发症发生率及患者家属对疗效的满意率组间比较,差异均有统计学意义(P<0.05)。结论:手法复位夹板外固定为桡骨远端骨骺骨折患者及临床医师提供了一种并发症少,创伤及痛苦小,简单及时,经济有效,患者家属满意度高的治疗方法选择,值得临床推广。Objective:To evaluate the clinical efficacy of closed manual reduction with splint and kirschner wire fixation for children patients with distal radius epiphyseal fracture.Methods:A retrospective analysis was carried out for 107 children with distal radial epiphyseal fracture who accepted treatment in author’s hospital from February 2016 to February 2019.Those patients were divided into observation group and control group according to manual reduction with splint and kirschner wire fixation.Imaging evaluation,Gartland-Werley score and satisfaction were documented and compared at follow-up time.Results:All patients were successfully followed up for an average of 18(12 to 32)months.No complication such as nonunion,delayed healing and premature closure of the distal radial epiphysis was found in all cases.There was no significant difference between the two groups in terms of palm tilt,ulnar deviation,wrist mobility,and Gartland-Werley score results(P>0.05).There were statistically significant differences in the incidence of complications and the satisfaction rate of patients between the groups(P<0.05).Conclusion:Manual reduction splint external fixation provides a treatment option for children and clinicians with distal radial epiphyseal fractures with fewer complications,less trauma and pain,simple and timely,cost-effective and high satisfaction of children’s families,which is worth clinical promotion.

关 键 词：桡骨远端骨骺骨折 手法复位 夹板固定 克氏针内固定 

分 类 号：R683.41[医药卫生—骨科学]