张氏回旋折顶推按法及杉树皮夹板治疗儿童桡尺骨远端双骨折32例疗效观察  

Efficacy observation on 32 cases of children with double fracture of distal radius and ulna treated by ZHANG’s convoluting and folding the top by pushing and pressing manipulation and fir bark splints

作　　者：王刚 赵瑛 谭浩林 郑辉 WANG Gang;ZHAO Ying;TAN Haolin;ZHENG Hui(Bone Setting Ward,Fuyang Orthopedic and Traumatologic Hospital of TCM in Hangzhou,Hangzhou,Zhejiang,311400,China)

机构地区：[1]杭州市富阳中医骨伤医院正骨病区,浙江杭州311400

出　　处：《中医儿科杂志》2021年第5期74-78,共5页Journal of Pediatrics of Traditional Chinese Medicine

摘　　要：目的观察张氏回旋折顶推按法及杉树皮夹板治疗儿童桡尺骨远端双骨折的临床疗效。方法选取2015年1月至2019年1月杭州市富阳中医骨伤医院正骨病区收治的32例桡尺骨远端双骨折患儿,采用张氏回旋折顶推按法及杉树皮夹板治疗,固定期间按照骨折分期配合我院自制颗粒剂中药姜枝活血汤加减内服。参照《中医病证诊断疗效标准》中骨折复位标准评定复位效果,采用Barton骨折疗效标准评定综合疗效;随访2~3年,观察不良反应发生情况。结果32例患儿解剖复位18例,近解剖复位8例,功能复位6例;所有患儿均获得随访,随访时间为2~3年,骨折均临床愈合,愈合时间3~6周,平均27 d。综合疗效:优29例,良2例,可1例。32例患儿中有3例受伤后即出现神经损伤症状,1周后症状缓解。结论张氏回旋折顶推按法及杉树皮夹板治疗儿童桡尺骨远端双骨折疗效确切,具有复位效果好、骨折愈合时间快等优点,值得临床推广应用。Objective To observe the clinical efficacy of ZHANG’s convoluting and folding the top by pushing and pressing manipulation and fir bark splints in the treatment of children with double fracture of distal radius and ulna.Methods From January 2015 to January 2019,32 cases of double fracture of distal radius and ulna admitted into bone setting ward of Fuyang Orthopedic and Traumatologic Hospital of TCM in Hangzhou were chosen and treated by ZHANG’s convoluting and folding the top by pushing and pressing manipulation and fir bark splints,during the fixation,according to the fracture stage,cooperated with oral administration of modified hospital-made Chinese medicinal Jiangzhi Huoxue Tang(姜枝活血汤).The reduction effect was assessed according to the fracture reduction criteria in Criteria of Diagnosis and Therapeutic Effect of Diseases and Syndromes in Traditional Chinese Medicine,and the comprehensive therapeutic effect was assessed by Barton fracture therapeutic effect criteria;The patients were followed up for 2 to 3 years and the incidence of adverse reactions was observed.Results Among the 32 cases,there were 18 cases of anatomical reduction,8 cases of near anatomical reduction and 6 cases of functional reduction.All the patients were followed up for 2-3 years.All fractures got union clinically,with union time of 3-6 weeks and an average of 27 days.The comprehensive curative effect was excellent in 29 cases,good in 2 cases and fair in 1 case.Three of the 32 children developed symptoms of nerve injury immediately after the injury,and the symptoms relieved 1 week later.Conclusion It has definite efficacy and has the advantages of good reduction effect and fast fracture union time to use ZHANG’s convoluting and folding the top by pushing and pressing manipulation and fir bark splints in the treatment of children with double fracture of distal radius and ulna.It is worthy of clinical promotion and application.

关 键 词：桡尺骨远端双骨折 儿童 回旋折顶推按法 杉树皮夹板 疗效观察 

分 类 号：R274.11[医药卫生—中医骨伤科学]