闭合手法复位U形螺旋石膏功能位固定治疗Colles骨折

目的:探讨Colles 骨折手法复位后U形螺旋石膏功能位固定的疗效。方法:2011年1月至2014年4月采用闭合手法复位U型螺旋石膏功能位固定47例Colles骨折患者,其中男12例,女35例;年龄8～72岁,平均54.8岁。伤后来院就诊时间40 min～3 d.患者均为闭合性骨折,无神经血管损伤。手法复位后采用U形螺旋石膏功能位固定,术后即可在健手牵引患侧拇指同时余四指伸曲功能握力练习。根据骨折愈合情况,4～8周拆除石膏,拆石膏后加强腕关节功能锻炼。结果:所有患者获得随访,时间6～12个月,平均6.4个月,骨折4～8周愈合。按改良Cooney 腕关节功能评价:优44例,良2例,可1例。结论:U形螺旋石膏功能位固定治疗Colles骨折,限制了拇指及拇伸肌腱活动,可以用健手牵引患侧拇指降低桡骨短缩率,有利于手及腕部的血液循环,肿胀易消退。

Treatment of Colles fracture with manipulative closed reduction and U-shaped gypsum functional fixation

Objective:To investigate the effect of U-shaped gypsum functional fixation after closed manipulative reduction for treatment of Colles' fractures.Methods:From January 2011 to April 2014,47 cases of Colles fracture were treated by closed reduction and U-shaped gypsum functional fixation including 12 males and 35 females with an average age of 54.8 years old ranging from 8 to 72 years old. The time from injury to treatment was 40 min to 3 d. The patients were closed fractures without neurovascular injury. After manual reduction and U-shaped gypsum functional fixation,the thumb of injury hand were traction by contralateral hand,and other fingers of injury hand were taken flexion to exercise grip function. According to the situation of fracture healing,plaster was removed at 4 to 8 weeks' fixation,the wrist joint functional exercise was strengthened after plaster removed.Results:All patients were followed up from 6 to 12 months with an average of 6.4 months,the fracture healing time was 4 to 8 weeks. According to the Cooney wrist function scoring:the result was excellent in 44 cases,good in 2 cases,1 case.Conclusion:U-shape gypsum functional fixation for treatment of Colles fracture limits the activity of thumb and extensor tendon,can reduce shortening of radial by traction of the injury thumb with the contralateral hand;it is good for blood circulation of hand and wrist,and swelling.