Purpose： To study the effects of surgical and nonoperative treatment on wrist function in patients with distal radius fracture. Methods： In total, 97 patients treated for distal radius fracture in the Department of ...Purpose： To study the effects of surgical and nonoperative treatment on wrist function in patients with distal radius fracture. Methods： In total, 97 patients treated for distal radius fracture in the Department of Orthopedic Trauma at the People＇s Hospital of Peking University from Jan. 2010 to Jun. 2016 were selected for outpatient follow-up, including manipulative reduction and dorsal splint fixation in 24 cases, bivalve cast fixation in 19 cases and open reduction and internal fixation in 54 cases. Evaluation was based on Sartiento＇s modification of the Gartland and Werley score. Efficacy was assessed with wrist pain as the focus. Results： The wrist function scores of the surgical group were better than nonoperative groups. There was no significant difference in wrist function scores between the dorsal splint group and the bivalve cast group. The ulnar wrist pain incidence had no significant difference in surgical and nonoperative groups. The displace rate in dorsal splint group was higher than other groups. Conclusion： The overall effect of surgical treatment of distal radius fracture is better than nonoperative treatment. The ulnar wrist pain incidence has no significant difference in these groups. Dorsal splint fixation is more prone to displace than bivalve cast fixation.展开更多
目的:腕手矫形器是一种常见的上肢功能障碍康复辅具,对脑卒中后手功能障碍患者的疗效存在争议。该文系统评价腕手矫形器对脑卒中患者手功能障碍的康复效果。方法:系统检索中国知网、万方、维普、SinoMed、PubMed、Embase、Web of Scienc...目的:腕手矫形器是一种常见的上肢功能障碍康复辅具,对脑卒中后手功能障碍患者的疗效存在争议。该文系统评价腕手矫形器对脑卒中患者手功能障碍的康复效果。方法:系统检索中国知网、万方、维普、SinoMed、PubMed、Embase、Web of Science、Cochrane Library等数据库公开发表的腕手矫形器在脑卒中患者手功能康复中应用的随机对照试验,其中试验组采用腕手矫形器和常规康复治疗,对照组采用常规康复治疗,检索时限为各数据库建库到2024年7月。由2位研究者独立开展文献筛选、提取资料,并依据Cochrane风险偏倚评估工具评价文献质量,使用RevMan 5.4软件进行Meta分析。结果:最终纳入8篇文献,共305例患者。Meta分析结果显示:试验组改良Ashworth评分低于对照组[MD=-0.24,95%CI(-0.36,-0.12),P<0.0001],Fugl-Meyer上肢运动功能评分和改良Barthel评分[SMD=0.97,95%CI(0.51,1.43),P<0.0001;SMD=1.00,95%CI(0.05,1.94),P=0.04]均高于对照组,两组握力比较差异无显著性意义[MD=-0.89,95%CI(-5.37,3.58),P=0.70]。结论:腕手矫形器能够降低脑卒中患者腕手关节肌张力,提高患者手运动功能与日常生活活动能力,但对患者握力无明显改善。需注意的是,研究总样本量仅305例,且部分指标(如握力)仅纳入2篇文献,统计效力不足,未来需更多大样本、高质量的随机对照试验进行验证。展开更多
文摘Purpose： To study the effects of surgical and nonoperative treatment on wrist function in patients with distal radius fracture. Methods： In total, 97 patients treated for distal radius fracture in the Department of Orthopedic Trauma at the People＇s Hospital of Peking University from Jan. 2010 to Jun. 2016 were selected for outpatient follow-up, including manipulative reduction and dorsal splint fixation in 24 cases, bivalve cast fixation in 19 cases and open reduction and internal fixation in 54 cases. Evaluation was based on Sartiento＇s modification of the Gartland and Werley score. Efficacy was assessed with wrist pain as the focus. Results： The wrist function scores of the surgical group were better than nonoperative groups. There was no significant difference in wrist function scores between the dorsal splint group and the bivalve cast group. The ulnar wrist pain incidence had no significant difference in surgical and nonoperative groups. The displace rate in dorsal splint group was higher than other groups. Conclusion： The overall effect of surgical treatment of distal radius fracture is better than nonoperative treatment. The ulnar wrist pain incidence has no significant difference in these groups. Dorsal splint fixation is more prone to displace than bivalve cast fixation.
文摘目的:腕手矫形器是一种常见的上肢功能障碍康复辅具,对脑卒中后手功能障碍患者的疗效存在争议。该文系统评价腕手矫形器对脑卒中患者手功能障碍的康复效果。方法:系统检索中国知网、万方、维普、SinoMed、PubMed、Embase、Web of Science、Cochrane Library等数据库公开发表的腕手矫形器在脑卒中患者手功能康复中应用的随机对照试验,其中试验组采用腕手矫形器和常规康复治疗,对照组采用常规康复治疗,检索时限为各数据库建库到2024年7月。由2位研究者独立开展文献筛选、提取资料,并依据Cochrane风险偏倚评估工具评价文献质量,使用RevMan 5.4软件进行Meta分析。结果:最终纳入8篇文献,共305例患者。Meta分析结果显示:试验组改良Ashworth评分低于对照组[MD=-0.24,95%CI(-0.36,-0.12),P<0.0001],Fugl-Meyer上肢运动功能评分和改良Barthel评分[SMD=0.97,95%CI(0.51,1.43),P<0.0001;SMD=1.00,95%CI(0.05,1.94),P=0.04]均高于对照组,两组握力比较差异无显著性意义[MD=-0.89,95%CI(-5.37,3.58),P=0.70]。结论:腕手矫形器能够降低脑卒中患者腕手关节肌张力,提高患者手运动功能与日常生活活动能力,但对患者握力无明显改善。需注意的是,研究总样本量仅305例,且部分指标(如握力)仅纳入2篇文献,统计效力不足,未来需更多大样本、高质量的随机对照试验进行验证。
