高频超声引导下桡骨远端稳定性骨折的手法复位并小夹板外固定  

High-frequency ultrasound-guided manual reduction and small splint external fixation in the treatment of stable fractures of the distal radius

作　　者：周玉兰 袁德超 李英[1] 高涛 曾健 尹崇仿 杨基兰[1] Zhou Yulan;Yuan Dechao;Li Ying;Gao Tao;Zeng Jian;Yin Chongfang;Yang Jilan(Department of Ultrasound,Zigong Fourth People’s Hospital,Zigong 643000,Sichuan Province,China;Department of Orthopedics,Zigong Fourth People’s Hospital,Zigong 643000,Sichuan Province,China)

机构地区：[1]自贡市第四人民医院超声科,四川省自贡市643000 [2]自贡市第四人民医院骨科,四川省自贡市643000

出　　处：《中国组织工程研究》2022年第15期2377-2381,共5页Chinese Journal of Tissue Engineering Research

基　　金：四川省卫生健康委员会科研课题(20PJ275),项目负责人:袁德超;四川省医学会青年创新科研课题(Q19026),项目负责人:袁德超;自贡市重点科技计划创新苗子课题(2018CXMZ05),项目负责人:袁德超;自贡市第四人民医院院内培育课题,项目负责人:周玉兰。

摘　　要：背景:稳定性桡骨远端骨折经手法复位小夹板外固定能获得较满意疗效,但存在一定的盲目性,随着肌骨超声的发展,为引导辅助骨折复位、提高复位质量及成功率提供了可能性。目的:探讨高频超声引导下辅助手法复位并小夹板外固定治疗桡骨远端稳定性骨折的可行性。方法:2020年1-7月在自贡市第四人民医院诊断为单侧桡骨远端稳定性骨折患者100例,按照随机区组法分为试验组(50例)和对照组(50例),试验组患者接受高频超声引导下对桡骨远端骨折手法复位小夹板外固定,对照组采用徒手闭合复位小夹板外固定,采用改良Green与O’Brien评分评价腕关节功能,采用改良Sanniento评分评价影像学表现。随访12个月,比较两组首次复位成功率、腕关节功能评分、影像学评分差异。结果与结论:①试验组首次复位成功率优于对照组,差异有显著性意义(P<0.05);②在复位后即刻,试验组和对照组影像学评价优率分别为90.0%,62.0%,差异有显著性意义(P<0.05);在复位后2个月时,试验组和对照组影像学评价优率分别为80.0%,56.0%,差异有显著性意义(P<0.05);③在复位后2个月时,试验组和对照组腕关节功能评价优率分别为10.0%,8.0%,差异无显著性意义;在复位后12个月时,试验组和对照组腕关节功能评价优率分别为90.0%,66.0%,差异有显著性意义(P<0.05);④结果表明,高频超声引导下对桡骨远端稳定性骨折手法复位并小夹板外固定,能够提高复位成功率和复位质量,改善患者后期腕关节功能。BACKGROUND:Manual reduction with external fixation using small splint for stable distal radius fracture can achieve satisfactory results,but there is some blindness.Development of musculoskeletal ultrasound provides the possibility for ultrasound-assisted reduction of fractures,which improves the quality and successful rate of reduction.OBJECTIVE:To evaluate the feasibility of high-frequency ultrasound-guided manual reduction combined with small splint fixation in the treatment of stable fractures of the distal radius.METHODS:One hundred patients who were diagnosed with unilateral stable distal radius fracture at Zigong Fourth People’s Hospital from January 2020 to July 2020 were randomly divided into two groups(n=50 per group):an experimental group and a control group.Patients in the experimental group received high-frequency ultrasound-guided manual reduction and small splint fixation,and patients in the control group received the closed reduction and small splint fixation.Wrist function was evaluated by modified Green and O'Brien scoring systems,and radiological findings were evaluated by modified Sanniento scoring method.The initial reduction success rate,wrist function scores,and imaging scores were compared between the two groups during 12-month follow-up.RESULTS AND CONCLUSION:The success rate of initial reduction in the experimental group was significantly better than that in the control group(P<0.05).The excellent rate of imaging evaluation was 90.0%and 62.0%in the experimental group and the control group,respectively,immediately after reduction,and there was a significant difference between the two groups(P<0.05).At 2 months after reduction,the excellent rate of imaging evaluation was 80.0%and 56.0%in the experimental group and the control group,respectively,and there was a significant difference between the two groups(P<0.05).At 2 months after reduction,the excellent rate of wrist function evaluation was 10.0%and 8.0%in the experimental group and the control group,respectively,and there was no signif

关 键 词：桡骨远端骨折 稳定性骨折 高频超声 肌骨超声 手法复位 小夹板 超声引导 X射线 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]