手法整复杉树皮外固定结合皮牵引治疗小儿股骨干骨折疗效观察

为对名中医张绍富的手法整复杉树皮外固定结合皮牵引治疗小儿股骨干骨折的经验进行临床观察与疗效评价,以规范操作,便于推广.将153例小儿股骨干骨折采用多中心(4家医院)双盲随机(DME)1]法,分为两组,治疗组102例采用手法整复杉树皮外固定结合皮牵引治疗,对照组51例,采用手法整复石膏外固定治疗,分别进行临床疗效与卫生经济学评定.经1～3.5年(平均1.8年)的随访.结果显示,治疗组较对照组肿胀消退快,并发症减少,疼痛积分减少2.69分,临床愈合时间缩短5.7天,骨性愈合时间提前7.4天,肢体功能恢复至正常时间提前7.3天,远期疗效无差异,治疗费用明显减少.表明手法整复杉树皮外固定结合皮牵引治疗小儿股骨干骨折,能减轻患儿痛苦,缩短病程,疗效优良.

MANIPULATIVE REDUCTION, FIR - BARK EXTERNAL FIXATION AND SKIN TRACTION FOR TREATING CHILDREN'S FEMORAL SHAFT FRACTURE

The objective of the paper is to make clinical observation and therapeutic-effect evaluation on the treatment of children's femoral shaft fracture (CFSF) by manipulative reduction, fir-bark external fixation and skin traction (Zhang's therapy, that is, the experience of Zhang Shaofu, a famous TCM physician) so as to standardize the operations for the wide popularization. Using the double-blind and random method, 153 cases of CFSF in four hospitals were randomly divided into two groups: Group A (n = 102 cases) and Group B (n = 51 cases), which were treated by Zhang's therapy and by manual manipulations and plaster external fixation, respectively; the clinical therapeutic effects and medical economics of the two groups were evaluated, respectively. Through the follow-up of 1 to 3.5 years (Mean: 1.8 years), the results showed that in spite of no difference from Group B in the long-term results, Group A had a significant advantages over Group B in: rapid swelling disappearance, few complications, low medical cost and the decrease of painful score, clinical healing time, bony healing time and normal-limb-function recovery time by 2.69 points, 5.7 days, 7.4 days and 7.3 days respectively, suggesting that when used to treat CFSF, Zhang's therapy could decrease the patient's sufferings, shorten the treatment course and produce a good result.