手法整复结合可调节生物力学夹板治疗桡骨远端骨折的临床研究  

Manipulative reduction combined with adjustable biomechanical splint in the treatment of distal radius fractures

作　　者：许少刚[1] 黄万新[1] 赵家邦[1] Xu Shaogang;Huang Wanxin;Zhao Jiabang(Zhengzhou Orthopaedics Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市骨科医院,450000

出　　处：《中国实用医刊》2020年第21期21-24,共4页Chinese Journal of Practical Medicine

摘　　要：目的:观察手法整复联合可调节生物力学夹板治疗桡骨远端骨折的临床效果,为桡骨远端骨折治疗计划的拟定提供参考。方法:抽取郑州市骨科医院2019年6月至2020年6月收治的桡骨远端骨折患者72例,按随机数字表法分为对照组与观察组,每组38例,对照组采用手法整复联合管型石膏外固定治疗,观察组采用手法复位联合可调节生物力学夹板治疗。治疗后3个月,采用Gartland-Werley腕关节功能评分对两组腕关节功能恢复情况进行评估;分别于复位前、复位后6周,依据X线正侧位片对比两组患者的掌倾角、尺偏角恢复情况;比较两组术后并发症发生情况。结果:观察组腕关节功能恢复优良率(94.74%,36/38)优于对照组(60.53%,23/38),差异有统计学意义(P<0.05)。复位前及复位后6周,两组尺偏角、掌倾角比较差异均未见统计学意义(P均>0.05);与同组复位前比较,两组尺偏角、掌倾角均升高(P<0.05)。对照组并发症发生率为10.53%(4/38),观察组为2.63%(1/38),差异未见统计学意义(P>0.05)。结论:手法整复联合可调节生物力学夹板治疗桡骨远端骨折,与手法整复联合管型石膏外固定获得的尺偏角与掌倾角恢复效果相近,但前者腕关节功能恢复效果更好,且固定期间并发症少,患者整体获益较好。Objective:To observe the effects of manipulative reduction combined with adjustable biomechanical splint in the treatment of distal radius fracture,and to provide reference for the future treatment plan of distal radius fracture.Methods:A total of 72 patients with distal radius fractures treated in Zhengzhou Orthopaedics Hospital from June 2019 to June 2020 were selected.They were divided into control group and observation group according to the random number table method,with 38 cases in each group.The control group was treated by manual restoration combined with tubular gypsum external fixation,and the observation group was treated by manual reduction combined with adjustable biomechanical splint.The wrist function recovery of the two groups was evaluated by Gartland-Werley wrist function score 3 months after treatment.Before and 6 weeks after reduction,the palmar angle and ulnar angle were compared between the two groups according to the anteroposterior and lateral radiography.The postoperative complications were compared between the two groups.Results:The excellent recovery rate of wrist joint function in the observation group was 94.74%(36/38),higher than the 60.53%(23/38)in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the ulnar angle or palmar inclination between the two groups before and after reduction(P>0.05).The ulnar angle and palmar inclination increased in both group after reduction(P<0.05).There was no significant difference in the incidence of complications between control group(10.53%,4/38)and observation group(2.63%,1/38),P>0.05.Conclusions:Manipulative reduction combined with adjustable biomechanical splint in the treatment of distal radius fractures is similar to manual reduction combined with cast plaster external fixation in the recovery of ulnar angle and palmar inclination angle.However,the former has better recovery of wrist joint function,and fewer complications during fixation,and the patients can get better overall ben

关 键 词：桡骨远端骨折 手法整复 可调节生物力学夹板 腕关节功能 并发症 

分 类 号：R683.4[医药卫生—骨科学]