掌压复位法加压力垫夹板固定治疗具有手术指征的伸直型桡骨远端fernandez分型Ⅲ型骨折60例的临床研究  

Clinical study on the treatment of 60cases of extended fernandez typeⅢfracture of distal radius with surgical indications by palm pressure reduction and pressure pad splint fixation

作　　者：李萍萍 郑润杰 谢文博 LI Pingping;ZHENG Runjie;XIE Wenbo(Sichuan Orthopedic Hospital,Chengdu,Sichuan 610041,China;Ruian Hospital of Traditional Chinese Medicine,Ruian Zhejiang 325200,China)

机构地区：[1]四川省骨科医院,四川成都610041 [2]瑞安市中医院,浙江瑞安325200

出　　处：《四川中医》2024年第12期132-134,共3页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:研究掌压复位法加压力垫夹板固定治疗对具有手术指征的伸直型桡骨远端fernandez分型Ⅲ型骨折患者的临床效果。方法:选取具有手术指征的伸直型桡骨远端fernandez分型Ⅲ型骨折患者60例,随机分为A、B两组各30例。其中男性17例,女性43例;年龄24~88岁,其中中位数为57岁;A组患者采用掌压复位法加压力垫夹板固定治疗。B组患者采用手术治疗,分别比较手法整复后与手术后两组患者的掌倾角、尺偏角,桡骨高度3个指标以及治疗1年后采用jakim桡骨远端骨折疗效评分系统进行腕关节功能评分来比较两组患者临床治疗效果。结果:60例患者均获得随访,时间为12个月。两组患者治疗后均未出现腕关节关节面对合不良,下尺桡关节半脱位、脱位及骨关节炎改变等并发症。手术患者术后切口愈合良好,无感染,无再移位。具体数据如下:手法整复后与手术后两组患者的掌倾角(7.30±6.44,8.81±3.13,t=-1.123,P=0.271>0.05)、尺偏角(20.93±4.55,16.19±4.12,t=-5.221,P=0.000<0.05),桡骨高度(7.57±2.23,6.63±3.04,t=1.408,P=0.170>0.05),组间对比可以看出,A组和B组在掌倾角和桡骨高度的治疗上差异无统计学意义,但在尺偏角的治疗上,A组明显优于B组,经治疗6个月后,按上述疗效标准评定:临床主观指标(29.20±2.07,28.40±2.70,t=2.112,P=0.043<0.05),临床客观指标(28.90±1.95,28.80±1.86,t=0.551,P=0.586>0.05),放射学检查:桡骨角阳性(32.30±5.57,31.57±7.44,t=0.954,P=0.348>0.05),放射学检查:阴性(0.00±0.00,0.00±0.00),总分(90.73±9.13,88.70±10.61,t=1.076,P=0.291>0.05),除临床主观指标上A组优于B组外,在临床客观指标、放射学检查以及总体评分上,A组和B组差异无统计学意义。A组患者优24例,良1例,可4例,差1例,优良率83.3%;B组患者优20例,良4例,可3例,差3例,优良率80.0%。两组患者比较差异无统计学意义(Z=-0.882,P=0.378>0.05)。结论:在治疗具有手术指征的伸直型fernandez分Objective:To study the clinical effect of palm pressure reduction combined with pressure pad splint fixation on patients with type III extended distal radius Fernandez fracture with surgical indications.Method:Sixty patients with extended distal radius Fernandez type III fractures with surgical indications were selected and randomly divided into two groups,A and B,with 30cases in each group.Among them,there are 17males and 43females;age range from 24to 88years old,with a median of 57years old;group A patients were treated with palm pressure reduction method and pressure pad splint fixation.Group B patients were treated with surgery,and the clinical treatment effects of the two groups were compared by comparing the three indicators of palm angle,ulnar deviation angle,and radius height after manual reduction and surgery,as well as using the Jakim distal radius fracture efficacy scoring system for wrist joint function evaluation after one year of treatment.Result:All 60patients were followed up for 12months.After treatment,neither group of patients experienced any complications such as wrist joint misalignment,subluxation or dislocation of the lower ulnar and radial joints,or changes in osteoarthritis.The surgical patient had good postoperative incision healing,no infection,and no further displacement.The specific data are as follows:the palm angle(7.30±6.44,8.81±3.13,P>0.05),ulnar deviation angle(20.93±4.55,16.19±4.12,P<0.05),and radius height(7.57±2.23,6.63±3.04,P>0.05)of the two groups of patients after manual reduction and surgery.The inter group comparison shows that there is no statistically significant difference between Group A and Group B in the treatment of palm angle and radius height.However,in the treatment of ulnar deviation angle,Group A is significantly better than Group B.After 6months of treatment,According to the above efficacy criteria,clinical subjective indicators(29.20±2.07,28.40±2.70,P<0.05),clinical objective indicators(28.90±1.95,28.80±1.86,P>0.05),radiological examination:positiv

关 键 词：掌压法 压力垫 夹板固定 具有手术指征的伸直型桡骨远端fernandez分型Ⅲ型骨折折 中药外敷 

分 类 号：R683.41[医药卫生—骨科学]