特制牵引夹板与石膏固定治疗移位型桡骨远端骨折随机对照研究  

A randomized controlled study of special traction splint vs cast immobilization in the treatment of displaced distal radius fractures

作　　者：李鑫 殷渠东 韦旭明 杨澔侠 陆尧 刘军 芮永军 Li Xin;Yin Qudong;Wei Xuming;Yang Haoxia;Lu Yao;Liu Jun;Rui Yongjun(Department of Orthopaedics,Wuxi No.9 People’s Hospital Affiliated to Suzhou University,Wuxi 214062,China;Department of Orthopedics,Wuxi Xinwu District Xinrui Hospital,Wuxi 214060,China;Orthopedics and Traumatology,Wuxi No.9 People’s Hospital Affiliated to Suzhou University,Wuxi 214062,China)

机构地区：[1]苏州大学附属无锡市第九人民医院骨科,江苏无锡214062 [2]无锡市新吴区新瑞医院骨科,江苏无锡214060 [3]苏州大学附属无锡市第九人民医院骨伤科,江苏无锡214062

出　　处：《中国临床解剖学杂志》2023年第4期481-486,489,共7页Chinese Journal of Clinical Anatomy

基　　金：无锡市中管局课题(ZYKJ202010,ZYKJ202008);无锡市“太湖人才计划”顶尖医学团队课题(WXTMETTHP-07)。

摘　　要：目的探讨特制牵引夹板与石膏固定治疗移位型桡骨远端骨折的效果,阐明本牵引夹板治疗原理。方法将符合纳入标准、保守治疗70例移位型桡骨远端骨折随机分为实验组(牵引夹板固定,35例)和对照组(石膏固定,35例)。两组患者年龄、性别、骨折类型、固定时机和疼痛视觉模拟评分(VAS)等无统计学差异(P>0.05)。比较两组骨折愈合相关指标。结果实验组再移位、不可接受移位和手术率少于对照组,差异有统计学意义(P<0.05),两组骨折愈合和外固定时间无统计学差异(P>0.05)。所有患者随访10~18个月,平均12.2个月,末次随访,实验组桡骨高度和尺偏角优于对照组,差异有统计学意义(P<0.05),而掌倾角、尺桡侧倾范围、腕屈伸范围、旋转范围、手握力、VAS、自行评估量表评分(patientrated wrist evaluation,PRWE)和腕关节功能(Gartland-Werley)优良率比较,无统计学差异(P>0.05)。结论牵引夹板较石膏固定能更好维持桡骨远端骨折位置和桡骨高度,减少再移位和手术率。Objective To investigate the effect of special traction splint vs plaster immobolization in the treatment of distal radius fractures and clarify the mechanism of traction splint.Methods Total of 70 patients with displaced distal radius fractures treated conservatively were randomly divided into an experimental group(traction splint immobolization,35 cases)and a control group(plaster immobolization,35 cases).There was no significant difference in age,gender,fracture type and fixation timing,and visual analog scale(VAS)for pain between the two groups(P>0.05).The fracture healing and fixation time,redisplacement,unacceptable displacement,operation rate,radius height,radial inclination angle,palmar inclination,range of motion(ROM)of radial-ulnar inclination,flection-extension and rotation,VAS for pain,hand grip strength,patient-rated wrist evaluation(PRWE)and wrist functional recovery(Gartland-Werley’s method)were compared between the two groups.Results The re-displacement,unacceptable displacement and operation rate of the experimental group were less than those of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in fracture healing time and fixation time between the two groups(P>0.05).All the patients were followed-up for 10 to 18 months,with an average follow-up of 12.2 months.At the last follow-up,the radius height and radius inclination angle of the experimental group were better than those of the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the palmar inclination,ROMs of radiusulnar inclination,flection-extension and rotation,VAS,hand grip strength,patient-rated wrist evaluation(PRWE),and excellent to good rate of wrist function between the two groups(P>0.05).Conclusions Comparing with plaster,traction splint immobolization can better maintain the position of distal radius fracture and the height of radius,reduce the re-displacement and operation rate,and the overall effec

关 键 词：桡骨远端骨折 夹板 石膏 牵引夹板 纵向牵引 

分 类 号：R683.41[医药卫生—骨科学]