平乐郭氏正骨手法配合钢针撬拨复位治疗MasonⅡ型桡骨头骨折临床观察  

Clinical Observation of Pingle GUO’s Bone Setting Manipulation Combined with Steel Needle Prying Reduction in Treatment of MasonⅡType Radial Head Fracture

作　　者：霍青云 赵玉玲 陈志新 张杰 于翱瑞 覃国忠 羊政忠 李伟 HUO Qingyun;ZHAO Yuling;CHEN Zhixin;ZHANG Jie;YU Aorui;QIN Guozhong;YANG Zhengzhong;LI Wei(Shenzhen Pingle Orthopedics Hospital(Shenzhen Pingshan District Hospital of Traditional Chinese Medicine),Shenzhen 518118,China)

机构地区：[1]深圳平乐骨伤科医院(深圳市坪山区中医院),广东深圳518118

出　　处：《山东中医杂志》2024年第1期47-52,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20212206)。

摘　　要：目的:观察平乐郭氏正骨手法配合钢针撬拨复位治疗型桡骨头骨折的临床疗效。方法:选择MasonⅡ型桡骨头骨折患者68例,分为观察组37例和对照组31例,在常规术前冷疗、术后石膏固定等治疗基础上,对照组取切开复位微T形钛板内固定术,观察组采用平乐郭氏正骨手法配合钢针撬拨复位固定术。统计对比两组患者手术时间、术中出血量、住院时间、疼痛评分、肘关节功能Broberg-Morrey评分,并评价两种治疗方法安全性。所有患者随访1年。结果:经治疗,两组患者的疼痛评分均较治疗前降低,Broberg-Morrey评分均升高(P<0.05)。组间比较,观察组的手术时间、住院时间均较对照组短,术中出血量少于对照组,术后各个时间点的疼痛评分均低于对照组,Broberg-Morrey评分均高于对照组(均P<0.05)。在安全性方面,两组患者均未发生术后感染、神经损伤等严重并发症,观察组患者术后内固定物克氏针失效2例,对照组延迟愈合1例、骨化性肌炎1例,两组比较,差异无统计学意义(P>0.05)。结论:平乐郭氏正骨手法配合钢针撬拨复位固定治疗MasonⅡ型桡骨头骨折能获得良好的功能复位,达到骨折临床愈合,减少手术创伤,尽快恢复肘关节功能。Objective:To explore the clinical efficacy of Pingle GUO’s bone setting manipulation combined with steel needle prying reduction in the treatment of MasonⅡtype radial head fracture.Methods:A total of 68 patients with MasonⅡtype radial head fracture were randomly divided into the observation group(37 cases)and the control group(31 cases).On the basis of conventional preoperative and postoperative treatment,the control group was treated with open reduction micro-T-shaped titanium plate internal fixation,and the observation group was treated with Pingle GUO’s bone setting manipulation combined with steel needle prying reduction and fixation.The operative time,intraoperative blood loss,length of hospital stay,pain score and Broberg-Morrey score of elbow joint function were counted,and safety evaluation was carried out.All patients were followed up for 1 year.Results:After treatment,the pain scores of both groups were lower than those before treatment,and the Broberg-Morrey scores were increased(P<0.05).Compared with the control group,the operation time and hospital stay in the observation group were shorter than those in the control group,the amount of intraoperative blood loss was less than that in the control group,the pain scores at all time points after the operation were lower than those in the control group,and the Broberg-Morrey scores were higher than those in the control group(all P<0.05).In terms of safety,no serious complications such as postoperative infection and nerve injury occurred in the two groups.There were 2 cases of postoperative Kirschner needle failure in the observation group,1 case of delayed healing and 1 case of ossification myositis in the control group,and there was no statistically significant significance between the two groups(P>0.05).Conclusion:Pingle GUO’s bone setting manipulation combined with steel needle prying reduction and fixation can achieve good functional reduction,achieve clinical healing of fracture,reduce surgical trauma and restore elbow joint function as soon

关 键 词：桡骨头骨折 平乐郭氏正骨 钢针撬拨 微创治疗 Broberg-Morrey评分 微T形钛板 

分 类 号：R274.21[医药卫生—中医骨伤科学]