“双脊”触诊法辅助整复桡骨远端骨折的临床影像  

Clinical image of"dual spine"palpation assisted reconstruction of distal radius fractures

作　　者：兰万亨 蔡德正 黄锦 陈郑增 LAN Wanheng;CAI Dezheng;HUANG Jin;CHEN Zhengzeng(The Third Department of Orthopedics,Ningde Hospital of Traditional Chinese Medicine in Fujian Province,Ningde 352100,China)

机构地区：[1]福建省宁德市中医院骨三科,福建宁德352100

出　　处：《中国现代医生》2021年第34期72-76,共5页China Modern Doctor

基　　金：福建中医药大学校管科研课题(XB2018078)。

摘　　要：目的观察“双脊”触诊法辅助整复桡骨远端骨折的临床影像。方法选取2018年1月至2020年12月我科主治及以下医师门急诊治疗的桡骨远端骨折患者58例。纳入病例均行牵引-掌屈-尺偏手法整复、U型石膏固定。试验组于手法整复前、后分别行“双脊”触诊法触诊,评估移位程度及整复质量,对照组不进行上述方法触诊。整复前后分别拍摄腕关节正侧位片,测量影像学参数。观察两组患者影像学参数的区别。结果两组患者性别、年龄、AO分型、整复前掌倾角、尺偏角、关节面台阶、桡骨相对尺骨高度、正位最大移位距离、侧位最大移位距离比较,差异无统计学意义(P>0.05);整复后两组掌倾角、尺偏角、关节面台阶高度、桡骨高度比较,差异无统计学意义(P>0.05)。但试验组整复后残留正位最大移位、侧位最大移位均小于对照组,差异有统计学意义(P<0.05)。结论“双脊”触诊法有助于改善桡骨远端骨折整复质量。Objective To observe the clinical images of the"dual spine"palpation assisted in the reconstruction of distal radius fractures.Methods A total of 58 patients with distal radius fractures who were treated by our department′s attending physician or below in the outpatient emergency rooms from January 2018 to December 2020 were searched.All the included patients underwent traction-palm flexion-ulnar deviation manipulative reconstruction and U-shaped plaster fixation.The experimental group underwent"dual spine"palpation before and after manipulative reconstruction to assess the degree of displacement and the quality of reconstruction.The control group did not undergo the above-mentioned method of palpation.Before and after the restoration,the front and side views of the wrist joint were taken for measurement of the imaging parameters.The difference in imaging parameters between the two groups of patients was compared and observed.Results In terms of gender,age,AO classification,and palm inclination,ulnar deviation,articular surface step height,radius relative to ulna height,maximum displacement distance in the anterior position,and maximum displacement distance in the lateral position before restoration,there were no statistical differences between the two groups of patients(P>0.05).In terms of palm inclination,ulnar deviation,articular surface step height,radius height after restoration,there were no statistical differences between the two groups(P>0.05).However,the residual maximum anteroposterior displacement and the lateral maximal displacement of the experimental group after repositioning were smaller than those of the control group,with the differences statistically significant(P<0.05).Conclusion The"dual spine"palpation is conducive to improving the quality of restoration of distal radius fractures.

关 键 词：桡骨远端骨折 手法整复 触诊 放射影像学 保守治疗 

分 类 号：R274[医药卫生—中医骨伤科学]