吴门手法整复夹板固定治疗老年C型桡骨远端骨折45例  

45 Cases of Type C Distal Radius Fracture in the Elderly Treated by Wu Men Manipulation and Combined with Horse Manure Splint

作　　者：严杰伟 沈晓峰[2] 陆斌杰[2] 李宇卫[2] YAN Jiewei;SHEN Xiaofeng;LU Binjie;LI Yuwei(Nanjing University of Traditional Chinese Medicine,Nanjing 210046,China;Suzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine,Suzhou 215003,Jiangsu China.)

机构地区：[1]南京中医药大学,南京210046 [2]南京中医药大学附属苏州市中医医院

出　　处：《中国中医骨伤科杂志》2020年第10期25-29,34,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:回顾分析吴门骨伤桡骨远端骨折手法整复联合马粪纸夹板固定治疗老年C型桡骨远端骨折的临床疗效。方法:选取2018年10月至2019年5月接受治疗的45例老年C型桡骨远端骨折患者,按照AO分型系统中C型骨折C1,C2,C3分为A,B,C三组。三组均使用吴门骨伤桡骨远端骨折四步复位法整复并用马粪纸夹板进行稳定固定,定期随访复查腕关节正侧位X线片并调整扎带松紧度,采用统计学方法分析比较三组患者临床疗效、腕关节Green-O'Brien评分(疼痛程度、功能恢复、活动范围、握力等四个方面)及影像学测量指标(掌倾角、尺偏角及桡骨高度)。结果:治疗6个月后A组患者腕关节Green-O'Brien评分及影像学指标均显著优于B和C组,差异有统计学意义(P<0.05);A组临床疗效优良率为75.00%,高于B组的46.67%及C组的30.00%,差异有统计学意义(P<0.05)。结论:对于老年C型桡骨远端骨折,手法皆可获得良好的复位,但固定不一定适合每一型。联合马粪纸夹板固定比较适用于C1型老年桡骨远端骨折,可较好促进腕关节恢复,而对于C2和C3型则效果一般。Objective:To analyze the clinical efficacy for the treatment of type C distal radius fracture in the elderly by Wu Men manipulation and treatment combined with horse manure splint.Methods:45elderly patients with type C distal radius fractures who received treatment in the outpatient,emergency and ward of Suzhou Hospital of Traditional Chinese Medicine were selected from October 2018to May 2019.They were divide into A,B,C group according to C1,C2,C3type fracture.The Wu Men manipulation were used in three groups of the distal radius fractures for reduction with external fixation by horse manure splint.clinical efficacy,wrist Green-O'Brien score(the degree of pain,functional recovery,range,grip strength),imaging measurement(palm angle,foot angle and radial height)were documented and compared.External fixation were adjusted,and X ray test was used to check the bone position.Results:After 6months of treatment,the wrist Green-O'Brien score and imaging indexes of carpus in group A were significantly better than those of group B and C(P<0.05).The rate of excellent and good clinical efficacy in group A was 75.00%which was higher than that in group B(46.67%)and group C(30.00%).There were significant differences(P<0.05).Conclusion:For almost all type C distal radius fractures in the elderly,Wu Men manipulation can achieve good reduction,but fixation may not be suitable for each type.Fixation combining with horse manure splint is suitable for C1type of distal radius fracture and can better promote wrist recovery.However,for the type C2and C3fracture the efficacy is limited.

关 键 词：吴门骨伤手法 马粪纸夹板固定 桡骨远端骨折 临床疗效 

分 类 号：R683.41[医药卫生—骨科学]