陇中正骨手法配合两种外固定法治疗旋后内收型踝关节骨折临床观察
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摘要
目的:观察陇中正骨手法配合两种外固定方法治疗Lauge-Hansen旋后内收型踝关节骨折的临床疗效。方法:将旋后内收型踝关节骨折患者64例随机分为治疗组、对照组各32例,2组均先采用陇中正骨手法予以良好复位,之后治疗组采用新型低温热塑支具固定,对照组采用传统石膏外固定,随访12～22个月。采用Oler ud-Molander踝关节功能评分系统评价2组疗效,并观察并发症发生情况(严重红肿、严重瘙痒、皮肤压疮、骨折再移位)。结果:优良率治疗组为87. 5%,对照组为62.5%,2组比较差异有统计学意义(P<0. 05);并发症发生率治疗组为12. 5%,对照组为53.1%,2组比较差异有统计学意义(P<0. 05)。结论:采用陇中正骨手法配合低温热塑型支具治疗Lauge-Hansen旋后内收型踝关节骨折临床疗效优于配合传统石膏外固定治疗,而且并发症少。
Objective: To observe clinical effects of LongZhong′s bone-setting manipulation combined with two kinds of the fixation methods in treating Lauge-Hansen supination-adduction type ankle fracture. Methods: All 64 patients were randomized into the treatment group and the control group, 32 cases each group, the patients in both groups were resetted by LongZhong′ s bone-setting manipulation, and then the treatment group were fixed by low temperature thermoplastic orthosis, while the control group accepted external fixation by traditional plaster, they were followed from 12 to 22 months. Clinical effects of both groups were assessed by Olerud-Molander ankle function scoring system, the incidences of the complications(severe redness and swelling, severe itching, skin pressure sore, fracture displacement) were observed. Results: The excellence rate of the treatment group was 87.5%, higher than 62.5% of the control group, and the difference had statistical meaning(P<0.05); the incidence of the complications of the treatment group was 12.5%, lower than 53.1% of the control group, and the difference was statistically significant(P<0.05). Conclusion: LongZhong′s bone-setting manipulation combined with low temperature thermoplastic orthosis in treating Lauge-Hansen supination-adduction type ankle fracture could obtain better clinical effects of traditional plaster with fewer complications.
Objective: To observe clinical effects of LongZhong′s bone-setting manipulation combined with two kinds of the fixation methods in treating Lauge-Hansen supination-adduction type ankle fracture. Methods: All 64 patients were randomized into the treatment group and the control group, 32 cases each group, the patients in both groups were resetted by LongZhong′ s bone-setting manipulation, and then the treatment group were fixed by low temperature thermoplastic orthosis, while the control group accepted external fixation by traditional plaster, they were followed from 12 to 22 months. Clinical effects of both groups were assessed by Olerud-Molander ankle function scoring system, the incidences of the complications(severe redness and swelling, severe itching, skin pressure sore, fracture displacement) were observed. Results: The excellence rate of the treatment group was 87.5%, higher than 62.5% of the control group, and the difference had statistical meaning(P<0.05); the incidence of the complications of the treatment group was 12.5%, lower than 53.1% of the control group, and the difference was statistically significant(P<0.05). Conclusion: LongZhong′s bone-setting manipulation combined with low temperature thermoplastic orthosis in treating Lauge-Hansen supination-adduction type ankle fracture could obtain better clinical effects of traditional plaster with fewer complications.
引文
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[2]袁永忠.保守方法治疗踝关节骨折脱位106例体会[J].中国民族民间医药,2009,18(22):79.
[3]Olerud C,Molander H.A scoring system for symptom evaluation after ankle fractures[J].Arch Orthop Trauma Surg,1984,103(3):190-194.
[4]张铁良.踝关节骨折的诊断与治疗[J].中国骨与关节损伤杂志,2011,26(2):188-192.
[5]南学彦,毕军伟,赵道洲.赵道洲教授运用侧旋复位整复踝关节骨折经验小结[J].西部中医药,2015,28(6):45-46.
[6]邓强,李盛华,毕军伟,等.陇中旋转晃抖法治疗桡骨远端C型骨折78例[J].中国中医骨伤科杂志,2013,21(11):53-54.
[7]魏国俊,丁玉芬,郑恒恒,等.陇中正骨手法整复石膏外固定治疗踝关节骨折40例[J].西部中医药,2016,29(2):52-53.
[8]刘红喜,毕军伟,李盛华,等.陇中正骨流派系列疗法治疗Danis-Weber A型踝关节骨折48例[J].西部中医药,2017,30(5):24-26.
[9]任德华,侯勇.非手术疗法治疗踝部骨折脱位[J].中国骨伤,2012,28(1):62-65.
[10]安建原,周肃陵,周立亚,等.何氏正骨手法治疗三踝骨折的临床研究[J].中国中医骨伤科杂志,2010,18(7):25-27.
[11]朱瑾懿.不同治疗方式在旋后外旋型Ⅲ、Ⅳ度踝关节骨折中的应用[J].中外医疗,2017,38(30):42-43.
[12]韩万伟,唐翔.骨通贴膏配合手法复位联合夹板外固定治疗踝关节骨折的效果观察[J].临床合理用药杂志,2017,10(29):13-15.
[13]王朝敏.中医手法治疗踝关节骨折及脱位[J].中医临床研究,2015,7(32):117-118.
[14]殷浩,潘政军,陈光,等.手法复位低温热塑支具外固定治疗桡骨远端骨折临床观察[J].中国中医急症,2015,24(3):538-540.
[15]颜在生.手法复位低温热塑支具外固定治疗桡骨远端骨折临床观察[J].世界最新医学信息文摘,2016,16(81):79-82.
[16]徐向红,沈喜,曾蕾,等.低温塑料板材支具治疗Ⅰ型锤状指21例[J].实用手外科杂志,2012,26(2):186-187.