郑氏手法整复结合夹板中立板外固定治疗儿童桡骨远端骨骺骨折  

Zheng's manipulation combined with splint and neutral plate external fixation for treatment of distal radius epiphyseal fractures in children

作　　者：赵纯[1] 刘政 李静[1] ZHAO Chun;LIU Zheng;LI Jing(Sichuan Orthopaedic Hospital,Chengdu Sichuan 610041,China)

机构地区：[1]四川省骨科医院,四川成都610041

出　　处：《四川中医》2024年第9期160-163,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：四川省中医药管理局科学技术研究专项(编号:2021MS331);四川省干部保健委员会科研课题(编号:2021~605)。

摘　　要：目的:探讨郑氏手法整复结合夹板中立板外固定治疗儿童桡骨远端骨骺骨折的手法操作及其临床疗效。方法:2022年3月~2023年9月收治的桡骨远端骨骺骨折患儿46例,采取郑氏手法整复结合夹板中立板外固定治疗。复位前、复位后即刻、复位后6月测量腕关节桡骨高度、桡骨掌倾角、桡骨尺偏角,采用Gartland-Welley评估量表评价腕关节功能,记录患者压疮、张力性水泡、皮肤红疹、骨折不愈合、骨筋膜室综合征、压迫性神经麻痹等并发症发生情况。结果:复位后即刻测量桡骨高度为10.71±2.25mm,桡骨掌倾角为12.84±3.63°,桡骨尺偏角为22.47±4.31°,均较复位前明显改善,差异有统计学意义(P<0.05)。复位后6月患者Gartland-Werley腕关节功能评分总分显著低于复位前,差异有统计学意义(P<0.05)。且主观评价、客观评价、残余畸形、并发症得分四项指标均明显低于复位前,差异有统计学意义(P<0.05)。根据Gartland-Welley评分结果:优39例,良7例,优良率为100%。结论:郑氏手法整复结合夹板中立板外固定治疗儿童桡骨远端骨骺骨折具有复位成功率高、临床疗效突出、安全性高、并发症少的特点,值得临床推广应用。Purpose:To study the manipulation and clinical efficacy of Zheng's manipulation combined with splint and neutral plate external fixation in treating distal radius epiphyseal fractures in children.Methods:46 children with distal radius epiphyseal fractures were admitted between January 2022 and June 2023.They were treated with Zheng's manoeuvre combined with splint and neutral plate external fixation.They were followed up for 6 months at 3 days,1 week,2 weeks,3 weeks and 4 weeks after the treatment.Fracture reduction and healing were assessed on the basis of X-ray images,and wrist joint function was assessed using the Gartland-Welley scoring system.Results:All 46 children with distal radius epiphyseal fractures have achieved the clinical standard of bone healing,with normal alignment of the lower ulnar radial joint,equal length of the left and right radii,normal ulnar deviation angle and palmarinclination angle.In addition,none of the children had premature closure of the distal radius epiphyses.According to the Gartland Welley score,39 cases were excellent,7 cases were good,and the excellent and good rates were 100%.Conclusion:Zheng's manual reduction combined with splint and neutral plate external fixation for treating distal radius epiphyseal fractures in children has the characteristics of high reduction rate,definite therapeutic effect,high safety,and few complications,which is worthy of clinical promotion and application.

关 键 词：桡骨远端骨骺骨折 闭合复位 外固定 骨骺损伤 

分 类 号：R683.41[医药卫生—骨科学]