手法复位小夹板固定配合接骨续筋汤治疗老年骨质疏松性Colles骨折临床观察

目的 观察手法复位小夹板固定配合接骨续筋汤治疗老年骨质疏松性Colles骨折的临床疗效。方法 将68例老年骨质疏松性Colles骨折患者随机分为治疗组和对照组，每组34例。两组患者均接受手法复位小夹板固定治疗，并给予常规治疗，治疗组在此基础上内服接骨续筋汤治疗。观察并记录两组患者治疗前，治疗1、2周后视觉模拟评分（visual analogue scale,VAS）,患侧肿胀情况，治疗4、8周后骨折愈合X线评分，并记录骨折愈合时间；骨折愈合后采用Garland-Werley评分对腕关节的活动功能进行评价；治疗90 d后，对两组患者的临床疗效进行评价。结果 治疗1、2周后，两组VAS评分及患侧肿胀度均较治疗前明显降低（P<0.05），且治疗组VAS评分和患侧肿胀度均明显低于对照组（P＜0.05）。治疗8周后，两组骨折愈合X线评分均较治疗4周后显著上升（P＜0.05），且治疗组骨折愈合X线评分明显高于对照组（P＜0.05）。与对照组比较，治疗组骨折愈合时间显著缩短（P＜0.05），Garland-Werley评分显著降低（P＜0.05）。治疗90 d后，两组临床疗效的差异有统计学意义（P＜0.05），治疗组临床疗效优于对照组。结论 在手法复位小夹板固定基础上服用接骨续筋汤可提高老年骨质疏松性Colles骨折的疗效，能有效缓解患者骨折后疼痛、肿胀程度，缩短骨折愈合时间，改善腕关节活动功能。

Clinical Effect of Manual Reduction and Small Splint Fixation Combined with Jiegu Xujin Decoction in Treatment of Elderly Osteoporotic Colles Fractures

Objective To investigate the clinical effect of manual reduction and small splint fixation combined with Jiegu Xujin Decoction in the treatment of elderly osteoporotic Colles fractures. Methods A total of 68 elderly patients with osteoporotic Colles fracture were randomly divided into treatment group and control group, with 34 patients in each group. The patients in both groups were given manual reduction, small splint fixation, and conventional treatment, and those in the treatment group were also given oral administration of Jiegu Xujin Decoction. Visual Analogue Scale (VAS) score and swelling of the ipsilateral side were observed before treatment and after 1 and 2 weeks of treatment; X-ray score of fracture healing was observed after 4 and 8 weeks of treatment, and time to fracture healing was observed; Garland-Werley score was used to evaluate the movement function of the wrist joint after fracture healing; clinical outcome was evaluated after 90 days of treatment. Results After 1 and 2 weeks of treatment, both groups had significant reductions in VAS score and swelling of the ipsilateral side (P<0.05), and the treatment group had significantly lower VAS score and degree of swelling than the control group (P<0.05). After 8 weeks of treatment, both groups had a significant increase in the X-ray score of fracture healing since 4 weeks of treatment (P<0.05), and the treatment group had a significantly higher X-ray score than the control group (P<0.05). Compared with the control group, the treatment group had a significantly shorter time to fracture healing (P<0.05) and a significant reduction in Garland-Werley score (P<0.05). There was a significant difference in clinical outcome between the two groups after 90 days of treatment (P<0.05), and the treatment group had a better clinical outcome than the control group. Conclusion Manual reduction and small splint fixation combined with Jiegu Xujin Decoction can improve the clinical outcome of elderly osteoporotic Colles fractures, effectively alleviate pain and swelling after fractures, shorten the time to fracture healing, and improve the movement function of the wrist joint.