吴门手法整复夹板固定治疗桡骨远端骨折的临床观察  

Clinical Observation of Wu Men Bone-Setting Manipulation and Splint Fixation on the Treatment of Distal Radius Fractures

作　　者：张龙[1] 沈晓峰[2] 俞鹏飞[2] 周宇 刘昱江 汪松林 占戴昕鹏 李宇卫[2] ZHANG Long;SHEN Xiaofeng;YU Pengfei;ZHOU Yu;LIU Yujiang;WANG Songlin;ZHAN-DAI Xinpeng;LI Yuwei(Nanjing University of Chinese Medicine,Nanjing 210046,China;Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine,Suzhou 215000,Jiangsu China)

机构地区：[1]南京中医药大学,南京210046 [2]南京中医药大学附属苏州市中医医院

出　　处：《中国中医骨伤科杂志》2022年第6期35-41,47,共8页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：江苏省科学技术厅社会发展面上项目(BE2021662)。

摘　　要：目的:回顾性分析吴门手法整复夹板固定治疗桡骨远端FrykmanⅤ、Ⅵ型骨折的临床疗效,探讨FrykmanⅤ、Ⅵ型桡骨远端骨折中斜形骨折的特殊性。方法:选取2018年1月至2021年1月就诊的80例桡骨远端FrykmanⅤ、Ⅵ型患者,按照Frykman分类法并根据桡骨远端横形或斜形骨折线形态,将FrykmanⅤ型、FrykmanⅥ型、类FrykmanⅤ型、类FrykmanⅥ型分为A、B、C、D四组。且均接受吴门手法整复夹板固定治疗,收集影像学测量指标(掌倾角、尺偏角、桡骨高度),末次随访采用腕关节Gartland-Werley评分,观察患者随访治疗期间出现的并发症,统计发生例数以评定临床疗效。结果:手法整复后即刻复查四组影像学测量指标略有差异,但差异无统计学意义(P>0.05),表明四组经手法整复后基线相当,具有可比性;治疗3个月A与B组影像学测量指标略有差异,但差异无统计学意义(P>0.05);治疗3个月C与D组影像学测量指标同样略有差异,但差异无统计学意义(P>0.05);治疗3个月后A、B组均明显优于C、D组,且差异均有统计学意义(P<0.05)。末次随访Gartland-Werley腕关节功能评分,A组临床疗效优良率为76.19%,B组为75.00%,明显高于C组的38.89%及D组的33.33%,差异有统计学意义(P<0.05)。结论:吴门手法整复夹板固定对于桡骨远端FrykmanⅤ、Ⅵ型骨折皆可获得良好的复位,但横形骨折临床疗效优于斜形骨折,故斜形骨折的分型及其固定方式有待于进一步探究。Objective:To analyze the clinical efficacy of Wu Men manipulation splint fixation in the treatment of FrykmanⅤandⅥdistal radius fractures,and to explore the particularity of oblique fractures in FrykmanⅤandⅥdistal radius fractures.Methods:80 patients with FrykmanⅤandⅥtypes of distal radius in hospital from January 2018 to January 2021 were selected.According to the Frykman classification method and the shape of the transverse or oblique fracture line of the distal radius,they were divided into A group(FrykmanⅤ),B group(FrykmanⅥ),C group(FrykmanⅤ-like)and D group(FrykmanⅥ-like).All patients received the Wu Men manipulative restoration and splint fixation.The imaging measurement indicators(palm inclination,ulnar declination,and radial height)were collected,and the wrist joint Gartland-Werley scores were used for the last follow-up.The complications during the follow-up treatment were observed,and the cases were counted to evaluate the clinical efficacy.Results:The imaging measurement indexes of the four groups were slightly different immediately after the manual restoration,but the difference was not statistically significant(P>0.05),indicating that the baselines of the four groups after manual restoration were similar and comparable.There was a slight difference in the imaging measures of group A and B after 3 months of treatment,but the difference was not statistically significant(P>0.05);the imaging measures of groups C and D were also slightly different after 3 months of treatment,but the difference was not statistically significant(P>0.05);groups A and B were significantly better than groups C and D after treatment for 3 months,and the difference was statistically significant(P<0.05).Gartland-Werley wrist function scores at last follow-up were shown that the excellent and good rate of clinical efficacy was 76.19%in group A,and 75.00%in group B,significantly higher than 38.89%in group C and 33.33%in group D,the difference was statistically significant(P<0.05).Conclusion:The Wu Men manipulati

关 键 词：吴门骨伤手法 马粪纸夹板固定 桡骨远端骨折 斜形骨折 临床疗效 

分 类 号：R683.41[医药卫生—骨科学]