杨氏旋后牵引法治疗成人移位尺桡骨双骨折87例  

Young's Supination Traction on the Treatment of 87 Adult Patients with Double Fracture of Displaced Ulna and Radius

作　　者：曹谦 成勇峰 潘晓 曹慎 杨韵琴 CAO Qian;CHENG Yongfeng;PAN Xiao;CAO Shen;YANG Yunqin(Xiangtan Chinese Medicine Hospital,Xiangtan 411100,Hunan China;The Second People's Hospital of Xiangtan,Xiangtan 411100,Hunan China)

机构地区：[1]湖南省湘潭市中医医院,湖南湘潭411100 [2]湖南省湘潭市第二人民医院

出　　处：《中国中医骨伤科杂志》2023年第11期66-71,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：湖南省中医药科技重点项目(2020024)。

摘　　要：目的:探讨采用杨氏旋后牵引法整复、小夹板外固定治疗成人移位尺桡骨双骨折患者的临床疗效及安全性。方法:自2015年2月至2023年4月,采用杨氏旋后牵引法整复、小夹板外固定的方法治疗成人尺桡骨双骨折移位患者87例,男40例,女47例;年龄为19~76岁,中位数为46.7岁;病程为2.0~4.8个月,中位数为2.7个月。均为新鲜移位的尺桡骨双骨折成人患者,致伤原因为:交通意外伤9例,重物砸伤8例,平地滑倒64例,高处坠落伤6例。其中合并严重内科疾患者23例,合并有下尺桡关节脱位的患者4例,合并其他部位损伤的患者8例,尺骨或桡骨多段骨折的患者4例。采用杨氏旋后牵引法复位小夹板配合直角托板固定后,随访观察患肢疼痛缓解、骨折愈合时间、功能恢复及并发症发生情况。结果:83例患者获随访,4例患者失访,失访率为4.6%。固定后残留前后移位达1/3以上的患者24例,固定后残留侧方移位达1/2以上者12例,固定后残留侧方成角16例,固定后同时残留前后方及侧方移位者13例。随访时间为1.5个月~4年,中位数为2.9个月。采用疼痛视觉模拟量表评分,治疗前为(7.95±1.35)分,治疗中为(2.14±0.61)分,治疗后为(0.84±0.13)分;平均愈合时间为(49.24±6.83)d;前臂功能评估(Anderson评分)优75例,良7例,可1例,优良率达98.7%。3例患者在早期出现压疮,经处理痊愈。结论:杨氏旋后牵引法复位、小夹板外固定治疗成人移位尺桡骨双骨折,患者痛苦少,医生学习曲线短,前臂旋转功能恢复优良率高,骨折愈合时间短,并发症少,经济简便,疗效确切,但需要耐心细致地与患者及其家属沟通,取得理解和配合。总而言之,此项技术简单有效,特别适合合并严重内科疾患无法手术的患者,可在临床特别是基层医疗单位推广应用。Objective:To investigate the clinical efficacy and safety of small splint external fixation with Young's supination traction on the treatment of adults with double fracture of displaced ulnar and radius.Methods:From February 2015 to April 2023,87 adult patients with displaced ulnar and radius double fractures(40 males and 47 females)were treated with small splint external fixation by Yang's supination traction method.Age ranged from 19 to 76 years old with 46.7 years old on average.The duration of the disease ranged from 2.0 to 4.8 months with a median of 2.7 months.All of them were adult patients with fresh displacement of both ulnar and radius fractures.The causes of injury were:traffic accident in 9 cases,heavy object injury in 8 cases,flat slip in 64 cases,falling from height in 6 cases.There were 23 patients with severe medical problems,4 patients with dislocation of the lower radioulnar joint,8 patients with other injuries,and 4 patients with multiple fractures of the ulna or radius.We followed up to observe the pain relief,fracture healing time,functional recovery and complications of the affected limb after restoration of the small splint with right angle bracket fixation by Young's supination traction method.Results:83 patients were followed up,4 patients were lost to follow-up,and the loss rate was 4.6%.There were 24 patients with more than 1/3 residual lateral displacement after fixation,12 patients with more than 1/2 residual lateral displacement after fixation,16 patients with residual lateral angle after fixation,and 13 patients with both anterior and posterior lateral displacement after fixation.The follow-up time was 1.5 months to 4 years with 2.9 months on average.The pain visual analogue scale was used to score before treatment(7.95±1.35)points,during treatment(2.14±0.61)points and after treatment(0.84±0.13)points.The mean healing time was(49.24±6.83)d.Forearm function assessment(Anderson score)was excellent in 75 cases,good in 7 cases and fair in 1 case,with an excellent and good rate of 98

关 键 词：旋后牵引法 尺桡骨双骨折 非手术治疗 小夹板 

分 类 号：R683.41[医药卫生—骨科学]