手法复位配合截楔管型石膏治疗儿童胫腓骨干骨折成角畸形30例  

Clinical Observation 30 Cases on the Treatment of Pediatric Angular Deformity of Tibia and Fibular Shaft Fractures with Manipulation and Wedge-cut Plaster

作　　者：许权 杨凤云[1] 吴凡 曹端广 张恒青 XU Quan;YANG Fengyun;WU Fan;CAO Duanguang;ZHANG Hengqing(The Affiliated Hospital of Jiangxi University of Chinese Medicine,Nanchang 330006,China)

机构地区：[1]江西中医药大学附属医院,南昌330006

出　　处：《江西中医药大学学报》2024年第1期45-48,共4页Journal of Jiangxi University of Chinese Medicine

基　　金：江西省中医药管理局科技计划项目(2019B035)。

摘　　要：目的:观察中医手法复位配合截楔管型石膏治疗儿童胫腓骨干骨折成角畸形的临床疗效。方法:选取2017年6月—2021年6月在江西中医药大学附属医院诊治的儿童胫腓骨干骨折成角畸形患者60例,均采用闭合中医手法复位后,随机分为观察组(截楔管型石膏固定)和对照组(常规石膏固定),各30例。治疗后1、2、4、6周及6个月进行随访,比较整复前后的X线片影像学结果,记录骨折端再移位情况、骨折端成角情况、VAS评分及有无并发症。结果:2组患者均得到有效随访。骨折复位后1周,观察组VAS评分明显高于对照组,差异有统计学意义(P<0.05)。复位后2周,2组VAS评分差异无统计学意义(P>0.05)。2组X线正位、侧位片骨折断端成角比较,复位前观察组分别为(18.2±7.8)°、(19.6±4.4)°,对照组分别为(17.7±6.0)°、(20.9±5.1)°,差异无统计学意义(P>0.05);复位后观察组分别为(2.1±0.7)°、(3.5±1.0)°,对照组分别为(6.6±2.4)°、(8.1±2.9)°,差异有统计学意义(P<0.05);6个月后随访,2组骨折断端成角差异无统计学意义(P>0.05)。6个月后随访,2组Flynn疗效优良率比较无显著性差异(P>0.05)。整复后前2周再移位比例比较,观察组(2/30)低于对照组(9/30),差异有统计学意义(P<0.05)。结论:中医手法复位配合截楔管型石膏治疗儿童胫腓骨干骨折成角畸形疗效确切,能有效纠正骨折断端成角及减少骨折再移位概率。Objective:To observe the clinical effect of traditional Chinese medicine manipulation combined with wedge-cut plaster in the treatment of angulation deformity of tibia and fibular shaft fractures in children.Methods:A total of 60 children with angular deformity of tibial and fibular shaft fractures who were diagnosed and treated in our hospital from June 2017 to June 2021 were selected,all of them were reduced by closed TCM manipulation,and randomly divided into observation group(wedge-cut plaster fixation)and Control group(plaster immobilization),30 cases in each group.Follow-up was performed at 1,2,4,6 weeks and 6 months after treatment.The imaging results of X-ray films before and after restoration were compared,and the fracture redisplacement,fracture angulation,VAS pain score,and the presence or absence of complications were recorded.Results:Both groups of patients were effectively followed up.One week after fracture reduction,the VAS pain score of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).At 2 weeks after reduction,there was no significant difference in the VAS pain score between the two groups(P>0.05).Before repositioning,on the frontal and lateral X-ray films,the observation group was(18.2±7.8)°,(19.6±4.4)°,the control group was(17.7±6.0)°,(20.9±5.1)°,respectively.The difference was not statistically significant(P>0.05);after reduction,in the anterior and lateral X-ray films,the observation group was(2.1±0.7)°,(3.5±1.0)°,and the control group was(6.6±2.4)°,(8.1±2.9)°,the difference was statistically significant(P<0.05);but after 6 months of follow-up,there was no statistical significance between the two groups(P>0.05).After 6 months of follow-up,there was no significant difference in the excellent and good rate of Flynn between the two groups(P>0.05).The proportion of re-displacement in the first 2 weeks after surgery was lower in the observation group(2/30)than in the control group(9/30),and the d

关 键 词：胫腓骨干骨折 管型石膏 楔形矫正 中医手法复位 儿童 

分 类 号：R274.12[医药卫生—中医骨伤科学]