健康成人前臂小夹板固定时压垫对腕关节局部压力的影响  

Effects of pressure pad on local wrist pressure when fixing forearm with small splints in healthy adults

作　　者：陈延荣[1] 孙长虹[1] 梁学振 邢海昌 周斌[1] 王明喜[1] 刘传强 CHEN Yanrong;SUN Changhong;LIANG Xuezhen;XING Haichang;ZHOU Bin;WANG Mingxi;LIU Chuanqiang(The Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China)

机构地区：[1]山东中医药大学附属医院,山东济南250014

出　　处：《中医正骨》2022年第10期27-31,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：山东省名老中医药专家传承工作室建设项目(鲁卫中发展字〔2018〕1号)。

摘　　要：目的:观察健康成人前臂小夹板固定时压垫对腕关节局部压力的影响。方法:招募2021年6—7月在山东中医药大学附属医院体检的健康成人,均按照Colles骨折小夹板固定法行前臂小夹板固定,采用微型薄膜压力传感系统测量未放置压垫时(无压垫组)和放置压垫时(有压垫组)腕关节休息位、伸直位、握拳位的桡骨茎突及Lister结节处压力。结果:①一般结果。共招募40例健康成人,男32例、女8例。年龄23~41岁,中位数26岁。受试者前臂长度,尺侧(23.6±3.4)cm、桡侧(21.4±2.3)cm、背侧(23.2±2.5)cm、掌侧(22.6±2.1)cm。受试者腕部周长(16.5±1.8)cm。小夹板长度,尺侧(18.5±2.1)cm、桡侧(17.4±2.3)cm、背侧(18.5±2.6)cm、掌侧(17.1±2.0)cm。4块小夹板宽度总和(12.9±1.1)cm。②桡骨茎突处压力。腕关节休息位、伸直位、握拳位时,无压垫组桡骨茎突处压力均低于有压垫组[(0.15±0.21)N,(0.34±0.33)N,t=3.868,P=0.001;(0.28±0.36)N,(0.61±0.40)N,t=2.581,P=0.015;(0.32±0.40)N,(0.53±0.50)N,t=3.306,P=0.003]。腕关节休息位、伸直位、握拳位桡骨茎突处压力的差异无统计学意义(无压垫组:F=1.342,P=0.267;有压垫组:F=1.497,P=0.229)。③Lister结节处压力。腕关节休息位时,无压垫组Lister结节处压力低于有压垫组[(0.13±0.17)N,(0.26±0.24)N,t=2.804,P=0.009]。腕关节伸直位、握拳位时,无压垫组与有压垫组Lister结节处压力比较,组间差异均无统计学意义[(0.38±0.49)N,(0.39±0.36)N,t=-0.112,P=0.912;(0.32±0.49)N,(0.35±0.40)N,t=0.785,P=0.439]。腕关节休息位、伸直位、握拳位Lister结节处压力的差异无统计学意义(无压垫组:F=2.769,P=0.068;有压垫组:F=1.256,P=0.290)。结论:健康成人前臂小夹板固定时,压垫可以增加桡骨茎突处压力,可能对骨折端起到维持复位效果的作用。Objective:To observe the effects of pressure pad on local wrist pressure when fixing forearm with small splints in healthy adults.Methods:The healthy adults who underwent medical examination in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from June 2021 to July 2021 were recruited,and their forearms were fixed with small splints according to the fixation method used for Colles'fracture.The pressures at radial styloid process and Lister's tubercle were measured in wrist resting,extending and clenching positions before(non-pressure pad group)and after placing the pressure pad(pressure pad group)by using miniature thin-film pressure sensing system.Results:①Forty healthy adults(32 males and 8 females)between the ages of 23 and 41(Median=26 yrs)were included in the study with the wrist circumference as 16.5±1.8 cm,and the forearm length as 23.6±3.4 cm,21.4±2.3 cm,23.2±2.5 cm and 22.6±2.1 cm in ulnar side,radial side,dorsal side and volar side respectively.The small splint length was 18.5±2.1 cm,17.4±2.3 cm,18.5±2.6 cm and 17.1±2.0 cm in ulnar side,radial side,dorsal side and volar side respectively with the total width as 12.9±1.1 cm.②The pressure at radial styloid process was lower in non-pressure pad group compared to pressure pad group in wrist resting,extending and clenching positions(0.15±0.21 vs 0.34±0.33 N,t=3.868,P=0.001;0.28±0.36 vs 0.61±0.40 N,t=2.581,P=0.015;0.32±0.40 vs 0.53±0.50 N,t=3.306,P=0.003).There was no statistical diference in the pressure at radial styloid process between the wrist positons of resting,extending and clenching(non-pressure pad group:F=1.342,P=0.267;pressure pad group:F=1.497,P=0.229).The pressure at Lister's tubercle was lower in non-pressure pad group compared to pressure pad group in wrist resting position(0.13±0.17 vs 0.26±0.24 N,t=2.804,P=0.009).There was no statistical difference in the pressure at Lister's tubercle between non-pressure pad group and pressure pad group in wrist extending and clenching positions(0.38±0.49

关 键 词：腕关节 健康志愿者 小夹板固定术 COLLES骨折 压垫 

分 类 号：R687.3[医药卫生—骨科学]