三种固定方式在桡骨远端骨折保守治疗中的疗效分析
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摘要
目的分析三种固定方式在桡骨远端骨折保守治疗中的疗效。方法选取2018年3～12月景德镇市中医医院骨伤科门诊及住院符合诊断及纳入标准病例的桡骨远端骨折患者72例,分为A组、B组和C组,每组24例。A组患者采用小夹板固定,B组患者采用石膏托固定,C组患者同时采用石膏托与小夹板,统计分析三组患者的掌倾角、尺偏角、VAS评分、Dienst评分、临床疗效。结果与保守复位前比较,三组患者保守复位后的掌倾角、尺偏角、Dienst评分均显著升高(P<0.05),VAS评分均显著降低(P<0.05);复位后与A组、B组患者比较,C组患者的掌倾角、尺偏角、Dienst评分均显著升高(P<0.05),VAS评分显著降低(P<0.05)。C组患者的腕关节功能恢复的优良率显著高于A组、B组(P<0.05)。结论石膏托与小夹板联合固定方式在桡骨远端骨折保守治疗中的疗效较小夹板固定、石膏托固定显著,更能有效提高患者的掌倾角、尺偏角,缓解患者疼痛,改善患者腕关节功能,值得在临床推广应用。
Objective To analyze the efficacy of three fixed methods in the conservative treatment of distal radius fracture. Methods A total of 72 patients with distal radius fractures who met the diagnosing and including standard in the Department of Orthopaedics and Traumatology, Jingdezhen City Hospital of Traditional Chinese Medicine from March to December 2018 were selected. They were divided into group A, group B and group C, with 24 cases in each group. Patients in group A were fixed with small splint. Patients in group B were fixed with plaster support and patients in group C were treated with plaster support and small splint. Then, the palm tilt angle, ulnar angle, VAS score, Dienst score, and clinical efficacy of the three groups were statistically analyzed. Results Compared with those before conservative restoration, the palm tilt angle, ulnar angle, VAS score, Dienst score, and clinical efficacy of the three groups were significantly increased after conservative restoration(P<0.05), and the VAS scores were significantly decreased(P<0.05). After restoration, the palm tilt angle, ulnar angle, VAS score, Dienst score, and clinical efficacy of group C were significantly increased compared with those in group A and group B(P<0.05), and VAS score was significantly lower(P<0.05). The excellent and good rate of wrist joint function recovery in group C was significantly higher than that in group A and B(P<0.05). Conclusion The combination of plaster support and small splint in the conservative treatment of distal radius fractures has more significant effect than small splint fixation or plaster support. It can effectively improve the patients' palm tilt angle and ulnar angle, relieve pain and improve the patients' wrist joint function, which is worthy of clinical application.
Objective To analyze the efficacy of three fixed methods in the conservative treatment of distal radius fracture. Methods A total of 72 patients with distal radius fractures who met the diagnosing and including standard in the Department of Orthopaedics and Traumatology, Jingdezhen City Hospital of Traditional Chinese Medicine from March to December 2018 were selected. They were divided into group A, group B and group C, with 24 cases in each group. Patients in group A were fixed with small splint. Patients in group B were fixed with plaster support and patients in group C were treated with plaster support and small splint. Then, the palm tilt angle, ulnar angle, VAS score, Dienst score, and clinical efficacy of the three groups were statistically analyzed. Results Compared with those before conservative restoration, the palm tilt angle, ulnar angle, VAS score, Dienst score, and clinical efficacy of the three groups were significantly increased after conservative restoration(P<0.05), and the VAS scores were significantly decreased(P<0.05). After restoration, the palm tilt angle, ulnar angle, VAS score, Dienst score, and clinical efficacy of group C were significantly increased compared with those in group A and group B(P<0.05), and VAS score was significantly lower(P<0.05). The excellent and good rate of wrist joint function recovery in group C was significantly higher than that in group A and B(P<0.05). Conclusion The combination of plaster support and small splint in the conservative treatment of distal radius fractures has more significant effect than small splint fixation or plaster support. It can effectively improve the patients' palm tilt angle and ulnar angle, relieve pain and improve the patients' wrist joint function, which is worthy of clinical application.
引文
[1]陈伟.三种不同外固定方式治疗桡骨远端骨折的疗效分析[D].河北医科大学,2015.
[2]王芳.桡骨远端骨折骨密度测量分析及钢板固定与石膏外固定治疗疗效观察对比及分析[D].南京中医药大学,2015.
[3]黄若景.3D打印计算机辅助设计小夹板外骨骼系统的研究[D].广州中医药大学,2015.
[4]郑斌.基于有限元的智能气囊小夹板治疗桡骨远端关节内骨折的生物力学研究[D].南京中医药大学,2016.
[5]黄永铨.补肾活血汤促进老年性桡骨远端骨折愈合的实验与临床研究[D].广州中医药大学,2015.
[6]王明鑫,尹望平,曾庆敏,等.尺骨短缩截骨术治疗桡骨远端骨折畸形愈合的生物力学研究[J].中华手外科杂志,2017,33(3):205-208.
[7]卜祥鹏,潘振宇,漆白文,等.掌背侧联合入路治疗桡骨远端C2、C3型骨折[J].武汉大学学报(医学版),2017,38(3):479-482.
[8]叶聪聪.肘关节恐怖三联征冠状突骨折部位与前臂骨间膜损伤的相关性研究[D].温州医科大学,2014.
[9]薛天乐,刘磊,鲁成,等.两种手术方式治疗C型桡骨远端骨折的疗效比较[J].蚌埠医学院学报,2017,42(7):945-947.
[10]吴咏德,蔡贤华,梁杰,等.骨瓣植骨联合外固定支架在青壮年桡骨远端骨折畸形愈合矫形中的应用[J].中华创伤骨科杂志,2016,18(7):634-637.
[11]刘伟,朱蒙,唐弯弯,等.两种不同的复位固定方式治疗不稳定型桡骨远端骨折疗效及安全性对比[J].解放军医药杂志,2017,29(10):42-45.
[12]李永耀,程灏,赵勇,等.夹板固定治疗尺骨茎突骨折的三维有限元分析[J].中国组织工程研究,2018,22(11):1737-1742.
[13]陈伟,宋朝晖.三种外固定方式治疗桡骨远端骨折的疗效分析[J].生物骨科材料与临床研究,2017,14(1):73-76.
[14]Shintani K,Kazuki K,Yoneda M,et al.Computer-Assisted Three-Dimensional Corrective Osteotomy for Malunited Fractures of the Distal Radius Using Prefabricated Bone Graft Substitute[J].J Hand Surg Asian Pac,2018,23(4):479-486.
[15]Farzad M,Layeghi F,Hosseini A,et al.Investigate the Effect of Psychological Factors in Development of Complex Regional Pain Syndrome Type I in Patients with Fracture of the Distal Radius:A Prospective Study[J].JHand Surg Asian Pac,2018,23(4):554-561.
[2]王芳.桡骨远端骨折骨密度测量分析及钢板固定与石膏外固定治疗疗效观察对比及分析[D].南京中医药大学,2015.
[3]黄若景.3D打印计算机辅助设计小夹板外骨骼系统的研究[D].广州中医药大学,2015.
[4]郑斌.基于有限元的智能气囊小夹板治疗桡骨远端关节内骨折的生物力学研究[D].南京中医药大学,2016.
[5]黄永铨.补肾活血汤促进老年性桡骨远端骨折愈合的实验与临床研究[D].广州中医药大学,2015.
[6]王明鑫,尹望平,曾庆敏,等.尺骨短缩截骨术治疗桡骨远端骨折畸形愈合的生物力学研究[J].中华手外科杂志,2017,33(3):205-208.
[7]卜祥鹏,潘振宇,漆白文,等.掌背侧联合入路治疗桡骨远端C2、C3型骨折[J].武汉大学学报(医学版),2017,38(3):479-482.
[8]叶聪聪.肘关节恐怖三联征冠状突骨折部位与前臂骨间膜损伤的相关性研究[D].温州医科大学,2014.
[9]薛天乐,刘磊,鲁成,等.两种手术方式治疗C型桡骨远端骨折的疗效比较[J].蚌埠医学院学报,2017,42(7):945-947.
[10]吴咏德,蔡贤华,梁杰,等.骨瓣植骨联合外固定支架在青壮年桡骨远端骨折畸形愈合矫形中的应用[J].中华创伤骨科杂志,2016,18(7):634-637.
[11]刘伟,朱蒙,唐弯弯,等.两种不同的复位固定方式治疗不稳定型桡骨远端骨折疗效及安全性对比[J].解放军医药杂志,2017,29(10):42-45.
[12]李永耀,程灏,赵勇,等.夹板固定治疗尺骨茎突骨折的三维有限元分析[J].中国组织工程研究,2018,22(11):1737-1742.
[13]陈伟,宋朝晖.三种外固定方式治疗桡骨远端骨折的疗效分析[J].生物骨科材料与临床研究,2017,14(1):73-76.
[14]Shintani K,Kazuki K,Yoneda M,et al.Computer-Assisted Three-Dimensional Corrective Osteotomy for Malunited Fractures of the Distal Radius Using Prefabricated Bone Graft Substitute[J].J Hand Surg Asian Pac,2018,23(4):479-486.
[15]Farzad M,Layeghi F,Hosseini A,et al.Investigate the Effect of Psychological Factors in Development of Complex Regional Pain Syndrome Type I in Patients with Fracture of the Distal Radius:A Prospective Study[J].JHand Surg Asian Pac,2018,23(4):554-561.