摘要
目的:探讨早期超掌指关节夹板固定辅助治疗闭合性桡骨远端骨折临床疗效。方法:140例闭合性桡骨远端骨折患者,采用随机数字表法分为A组(70例)和B组(70例);其中A组患者采用手法复位+超腕关节夹板固定治疗,B组患者采用手法复位+超掌指关节夹板固定+超腕关节夹板固定治疗;比较两组患者术后腕关节功能Gartland-Werley评分优良率,术后不同时间点Gartland-Werley评分,患者相关手腕评分(PRWE)满意度,术后掌倾角、尺偏角及桡骨茎突高度丢失值等。结果:A组和B组患者术后腕关节功能Gartland-Werley评分优良率分别为71.43%(50/70),95.71(67/70);B组患者术后腕关节功能Gartland-Werley评分优良率显著优于A组,差异有统计学意义(P<0.05);A组患者术后2、4、6及8周Gartland-Werley评分分别为(14.26±2.32)分,(10.13±1.79)分,(8.21±1.44)分,(4.08±0.75)分;B组患者术后2、4、6及8周Gartland-Werley评分分别为(11.31±2.10)分,(7.47±1.46)分,(5.05±1.01)分,(2.97±0.53)分;B组患者术后2、4、6及8周GartlandWerley评分均显著低于A组,差异有统计学意义(P<0.05);A组和B组患者术后PRWE评分满意度分别为78.57%(55/70),97.14(68/70);B组患者术后PRWE评分满意度显著高于A组,差异有统计学意义(P<0.05);A组患者术后掌倾角、尺偏角及桡骨茎突高度丢失值分别为(6.33±1.62)°,(6.51±1.75)°,(6.19±1.21)°;B组患者术后掌倾角、尺偏角及桡骨茎突高度丢失值分别为(4.70±1.23)°,(4.32±1.06)°,(5.45±0.94)°;B组患者术后掌倾角、尺偏角及桡骨茎突高度丢失值均显著少于A组,差异有统计学意义(P<0.05)。结论:早期超掌指关节夹板固定辅助治疗闭合性桡骨远端骨折可有效改善腕关节活动,提高患者治疗满意程度,并降低术后骨折再移位风险。
Objective： To investigate the clinical efficacy of early super metacarpophalangeal joint splint fixation assisted surgery for closed fracture of distal radius. Methods： 140 patients with closed fracture of distal radius were randomly divided into both group including A group（ 70 patients） with manipulative reduction ＋ super wrist splint fixation and B group（ 70 patients） with manipulative reduction ＋ super metacarpophalangeal joint splint fixation ＋ super wrist splint fixation; and the excellent and good rate of wrist joint funciton for Gartland- Werley scores,Gartland- Werley scores at different time points after surgery,patients- related wrist score（ PRWE） satisfaction and the loss values of palmar tilt,ulnar deviation and height of radial styloid process of both groups were compared. Results： The excellent and good rate of wrist joint funciton for Gartland- Werley scores after surgery of A group and B group were separately 71. 43%（ 50 /70）,95. 71（ 67 /70）. The excellent and good rate of wrist joint funciton for Gartland- Werley scores after surgery of B group was significantly better than A group（ P〈 0. 05）. The Gartland- Werley scores in 2,4,6 and 8 weeks after surgery of A group were separately（ 14. 26 ± 2. 32） points,（ 10. 13 ± 1. 79） points,（ 8. 21 ± 1. 44） points,（ 4. 08 ± 0. 75） points; the Gartland- Werley scores in 2,4,6 and 8 weeks after surgery of B group were separately（ 11. 31 ± 2. 10） points,（ 7. 47 ±1. 46） points,（ 5. 05 ± 1. 01） points,（ 2. 97 ± 0. 53） points. The Gartland- Werley scores in 2,4,6 and 8 weeks after surgery of B group was significantly better than A group（ P〈 0. 05）. The PRWE satisfaction after surgery of A group and B group were separately 78. 57%（ 55 /70）,97. 14（ 68 /70）. The PRWE satisfaction after surgery of B group was significantly better than A group（ P〈 0. 05）. The loss values of palmar tilt,ulnar deviation and height of radial styloid process of A group were separately（ 6. 33 ± 1. 62） °,（ 6. 51 ± 1. 75） °,（ 6. 19 ± 1. 21） mm; the loss values of palmar tilt,ulnar devia-tion and height of radial styloid process of B group were separately（ 4. 70 ± 1. 23） °,（ 4. 32 ± 1. 06） °,（ 5. 45 ± 0. 94）mm. The loss values of palmar tilt,ulnar deviation and height of radial styloid process of B group was significantly better than A group（ P〈 0. 05）. Conclusion： Early super metacarpophalangeal joint splint fixation assisted surgery for closed fracture of distal radius. can efficiently improve activity of wrist joint,higher patient satisfaction and reduce the postoperative fracture shift risk.
出处
《中华中医药学刊》
CAS
北大核心
2015年第3期758-760,共3页
Chinese Archives of Traditional Chinese Medicine
关键词
超掌指关节夹板
超腕关节夹板固定
手法复位
固定
桡骨远端骨折
super metacarpophalangeal joint splint fixation
super wrist splint fixation
manipulative reduction
fixation
distal radius fracture
