摘要
目的:观察老年桡骨远端骨折患者采取吴门正骨手法复位加小夹板外固定,联合骨折合剂内服治疗取得的临床疗效。方法:回顾性分析2018年6月至2020年2月采用本方法诊治的72例老年桡骨远端骨折患者,收集影像学指标(掌倾角、尺偏角、桡骨高度)、骨折愈合时间、腕关节功能(Mayo评分)及随访期间并发症发生率以评定患者的临床疗效。结果:所有患者均获得随访,平均随访时间(8.65±2.44)个月。掌倾角、尺偏角、桡骨高度在治疗后均有明显改善,治疗前与治疗后即刻(1 d)、6周、3个月间差异有统计学意义(P<0.01),但治疗后6周、3个月丢失严重(P<0.05)。治疗后6周、3个月、6个月患者腕关节Mayo功能评分分别为(45.23±4.95),(63.29±5.24),(82.46±8.27),差异均有统计学意义(P<0.01)。临床骨折愈合一般在拆除外固定后功能锻炼4周左右,平均为(10.44±2.55)周。10例患者出现张力性水疱,无其它严重并发症发生。结论:吴门正骨手法复位加小夹板外固定联合骨折合剂内服治疗老年桡骨远端骨折可以较好地复位并固定骨折端,恢复患者的腕关节功能,并发症发生率较低,中远期疗效较好,但固定时间较长,腕关节功能恢复较慢,且无法维持桡骨长度。
Objective:To observe the clinical efficacy of Wu Men bone-setting manipulation reduction and small splint external fixation combined with Guzhe mixture in treating senile distal radius fractures.Methods:72 elderly patients with distal radius fractures who were hospitalized from June 2018 to February 2020 were analyzed retrospectively.The imaging markers(palmar tilt,ulnar deviation,radius height),wrist function(Mayo score), fracture healing time and complications during follow-up time were collected to evaluate the clinical efficacy.Results:All patients were followed up for(8.65±2.44) months.The palmar tilt,ulnar deviation,radius height were significantly improved after treatment.There were significant differences between before treatment and immediately after treatment(1 d),6 weeks and 3 months(P<0.01),but these parameters significantly reduced 6 weeks and 3 months after treatment(P<0.05).After 6 weeks,3 months and 6 months of treatment,the Mayo function scores of wrist joint were(45.23±4.95),(63.29±5.24),(82.46±8.27).There were statistically significant differences(P<0.01).The clinical fracture healing was usually about 4 weeks after the removal of external fixation with(10.44±2.55) weeks on average.Tension blisters were found in 10 patients without other serious complications.Conclusion:Wu Men bone-setting manipulation reduction and small splint external fixation combined with Guzhe mixture can better fix the fracture and restore the wrist function of patients.The incidence of complications is low,and the medium and long-term curative effect is good,but the fixation time is long and the recovery of wrist joint function is slow and unable to well maintain the radius.
作者
刘锦涛
戴宇祥
姜宏
孙轶韬
李晓春
冯秋香
钱祥
马奇翰
LIU Jintao;DAI Yuxiang;JIANG Hong;SUN Yitao;LI Xiaochun;FENG Qiuxiang;QIAN Xiang;MA Qihan(Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Suzhou 215009,Jiangsu China)
出处
《中国中医骨伤科杂志》
CAS
2020年第12期30-35,共6页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
苏州市科技局科技发展计划项目(SS201877)
苏州市科技局科技发展计划项目(SYSD2019218)
江苏省卫计委青年医学人才项目(QNRC2016257)
苏州市卫健委第五批姑苏卫生人才培养项目(GSWS2019066)。
关键词
老年桡骨远端骨折
吴门伤科正骨手法复位
小夹板
骨折合剂
临床疗效
senile distal radius fractures
Wu Men bone-setting manipulation reduction
small splint
Guzhe mixture
clinical efficacy
