杉树皮夹板联合早期石膏托外固定治疗B型老年桡骨远端骨折
Treatment of Type B Distal Radius Fracture in the Elderly with Fir Bark Splint Combined with Early Plaster External Fixation
黄平 1陈先进 1戴俭华 1周晨 1吴刚 1熊思琦2
作者信息
- 1. 安徽省芜湖市中医医院 安徽芜湖 241002
- 2. 安徽中医药大学附属芜湖市中医医院专硕研究生培养基地 安徽芜湖 241002
- 折叠
摘要
目的:探讨手法复位杉树皮夹板联合早期石膏托外固定治疗B型老年桡骨远端骨折的临床疗效及优越性.方法:采用单中心对照试验,2020年6月—2022年5月芜湖市中医医院骨科急诊要求保守治疗的老年桡骨远端骨折患者,分为2组,联合外固定组40例,男16例,女24例,年龄65～78岁,平均年龄68.3岁;夹板外固定组40例,男17例,女23例,年龄65～76岁,平均年龄67.8岁.所有病例均行手法复位,复位后第3天及第1、2、6周来院复查,其中第2、6周复查X线片,观察骨折对位、对线及愈合情况,评估患肢功能恢复、骨质疏松情况.结果:77例患者获随访3～12个月,平均随访6.2个月,3例失访.记录伤后6周尺偏角、掌倾角、桡骨高度的改善情况,第2掌骨骨质疏松情况,采用腕关节患者自评量表和上肢功能评分表评价伤后6个月及1年功能恢复情况,并行统计学分析.结论:手法复位杉树皮夹板外固定能够较好地维持复位后骨折的对位,而早期联合石膏托外固定,可以维持复位后的特殊体位,且不影响后期功能康复,适用于要求保守治疗的老年桡骨远端骨折患者.
Abstract
Objective:To explore the clinical efficacy and superiority of manual reduction of fir bark splint combined with early plaster external fixation in the treatment of type B distal radius fracture in the elderly.Methods:A single-center controlled trial was performed.Elderly patients with distal radius fracture who required conservative treatment in the orthopedic emergency department of Wuhu Traditional Chinese Medicine Hospital from June 2020 to May 2022 were divided into two groups.There were 40 cases in the combined external fixation group,including 16 males and 24 females,aged 65-78 years old,with an average age of 68.3 years old;there were 40 cases in the splint external fixa-tion group,including 17 males and 23 females,aged 65-76 years old,with an average age of 67.8 years old.All cases underwent manual reduction and came to the hospital for reexamination on the 3rd day and 1,2,and 6 weeks after reduction.X-rays were reexamined at 2 and 6 weeks to observe the fracture alignment,alignment and healing,and to evaluate the functional recovery and osteoporosis of the affected limb.Results:77 patients were followed up for 3 to 12 months,with an average follow-up of 6.2 months,and 3 patients were lost to follow-up.The improvement of ulnar de-viation angle,palmar inclination angle,and radius height at 6 weeks after injury,as well as osteoporosis of the second metacarpal bone were recorded.The wrist joint patient self-rating scale and upper limb function score table were used to evaluate the functional recovery at 6 months and 1 year after injury,and statistical analysis was performed in paral-lel.Conclusion:Manual reduction and fir bark splint external fixation can better maintain the alignment of the fracture after reduction,and early combined plaster splint external fixation can maintain the special position after reduction without affecting the functional rehabilitation in the later stage.It is suitable for elderly patients with distal radius frac-tures who require conservative treatment.
关键词
桡骨远端骨折/老年人/小夹板固定/石膏固定/手法复位Key words
Distal radius fracture/Elderly/Small splint fixation/Plaster fixation/Manual reduction引用本文复制引用
基金项目
国家中医药管理局陈先进全国名老中医药专家传承工作室项目(国中医药人教函[2022]75号)
安徽省卫生健康委员会中医药领军人才项目(皖中医药发展秘[2023]35号)
安徽省教育厅高校自然科学研究重点项目(KJ2021A1284)
芜湖市卫生健康委员会"华佗计划"卫生骨干人才项目(芜卫组[2021]134号)
出版年
2024
国家科技期刊平台
NSTL
万方数据