“螯足”石膏外固定治疗桡骨远端骨折的疗效分析  

Analysis of“cheliped”plaster fixation in the treatment of distal radius fracture

作　　者：许福生 张伟 夏平[1] XU Fu-sheng;ZHANG Wei;XIA Ping(Department of Orthopaedics,The First Hospital of Wuhan,Wuhan,Hubei,430022,China)

机构地区：[1]武汉市第一医院骨科,湖北430022

出　　处：《中国骨与关节杂志》2021年第12期885-888,共4页Chinese Journal of Bone and Joint

摘　　要：目的评价“螯足”石膏外固定技术治疗桡骨远端骨折的临床应用效果。方法2017年3月至2018年3月,回顾性分析42例移位的桡骨远端关节外骨折患者,其中男8例,女34例,平均年龄68岁。将桡骨远端骨折按常规方法充分复位后,采用“螯足”石膏对骨折进行固定。将石膏两臂分别置于手掌的掌侧及背侧,石膏主轴置于前臂桡侧,主轴两侧贴于前臂掌侧及背侧,Y形交叉点位于桡骨茎突桡侧。临床疗效评价的指标包括骨折愈合、疼痛、握力、腕关节活动范围,影像学评价包括尺偏角、掌倾角、尺骨变异及再移位。结果本组所有患者获得平均1年的随访,骨折平均愈合时间5.2周。42例骨折中有1例(2.4%)发生再次移位。5例由于手腕肿胀严重而调整石膏的松紧度,但无1例发生再移位。复位后、1年掌倾角分别为(7.0±2.1)°、(6.7±2.6)°,差异无统计学意义(P>0.05)。复位后、1年尺偏角分别为(21.7±2.5)°、(21.2±2.3)°,差异无统计学意义(P>0.05)。复位后、1年尺骨变异分别为(1.6±1.8)mm、(1.7±1.2)mm,差异无统计学意义(P>0.05)。1年随访时,患侧与健侧腕关节活动范围的比值:掌屈(95.8±4.6)%,背伸(94.2±3.8)%,旋后(92.4±4.9)%,旋前(99.7±5.6)%;患侧与健侧握力的比值:(94.8±5.4)%;疼痛视觉模拟评分(visual analogue scale,VAS)平均(1.2±0.4)。结论“螯足”石膏外固定技术治疗桡骨远端骨折,操作简单、可重复性强,能有效维持桡骨远端骨折的复位。Objective To evaluate the clinical value of“cheliped”plaster fixation for the treatment of distal radius fracture.Methods Clinical data of 42 patients with unilateral distal radius fracture were retrospectively reviewed between March 2017 and March 2018.There were 8 males and 34 females with the mean age of 68 years.Y-shaped plaster immobilisation was performed after adequate close reduction.Two arms of the Y-shaped plaster were placed on the volar side and the dorsal side of the palm,and the main axis of the plaster was placed on the side of the radius of the forearm.Both sides of the main axis were attached to the volar side and the dorsal side of the forearm,and the Y-shaped intersection was located on the side of the radius styloid.Indexes including union,pain(VAS),grip strength,joint ROM,volar tilt,ulnar inclination,ulnar variance and redisplacement were measured.Results All patients were followed up for an average of 1 year,and the average healing time of the fracture was 5.2 weeks.Redisplacement occurred in 1 case(2.4%).The tightness of the plaster was adjusted due to severe swelling of the wrist in 5 cases,but no redisplacement occurred.Indexes after reduction and 1 year postoperatively:volar tilt,(7.0±2.1)°and(6.7±2.6)°,not statistically significant(P>0.05);ulnar inclination,(21.7±2.5)°and(21.2±2.3)°,not statistically significant(P>0.05);ulnar variance,(1.6±1.8)mm and(1.7±1.2)mm,not statistically significant(P>0.05).Ratio of affected to normal wrist ROM 1 year postoperatively:flexion(95.8±4.6)%,extension(94.2±3.8)%,supination(92.4±4.9)%,pronation(99.7±5.6)%.Ratio of affected to normal grip strength:(94.8±5.4)%.VAS scored(1.2±0.4)on average.Conclusions The“cheliped”plaster fixation is simple and reliable in the treatment of distal radius fracture,which will effectively maintain the reduction of distal radius fracture.

关 键 词：桡骨骨折 石膏 外科 骨折固定术 治疗结果 

分 类 号：R683.4[医药卫生—骨科学]