手法复位小夹板固定治疗骨质疏松型桡骨远端骨折效果观察

目的 探讨手法复位杉树皮小夹板固定治疗骨质疏松型桡骨远端骨折的临床疗效.方法 2012年4月至2015年6月期间在佛山中医院三水医院骨科治疗的98例骨质疏松型桡骨远端骨折患者以数字表法随机分为观察组和对照组,每组49例,观察组患者给予手法复位小夹板固定治疗,对照组患者给予切开复位内固定治疗,比较两组患者腕关节评分优良率、骨密度、掌倾角、尺偏角、手背肿胀消退时间、疼痛缓解时间和骨折愈合时间.结果 观察组患者的腕关节评分优良率为85.7%,明显高于对照组的69.4%,差异有统计学意义(P<0.05);观察组和对照组患者治疗前的骨密度分别为(-2.588±0.089)与(-2.562±0.085),差异无统计学意义(P>0.05),治疗后观察组的骨密度为(-2.601±0.083),明显高于对照组的(-2.978±0.085),差异有统计学意义(P<0.05);治疗前观察组和对照组患者的掌倾角分别为(4.63±1.42)°、(4.56±1.50)°,尺偏角分别为(15.21±2.83)°、(15.48±2.85)°,差异均无统计学意义(P>0.05),治疗后观察组和对照组患者的掌倾角分别为(7.99±1.44)°、(7.92±1.48)°,尺偏角分别为(19.29±2.88)°、(19.24±2.91)°,均较治疗前明显增加,差异均有统计学意义(P<0.05),但治疗后两组间比较差异均无统计学意义(P>0.05);观察组患者的手背肿胀消退时间、疼痛缓解时间、骨折愈合时间分别为(6.3±1.7)d、(3.3±0.9)d、(34.1±8.9)d,均明显短于对照组的(9.8±2.1)d、(4.9±0.8)d、(45.1±9.3)d,差异均有统计学意义(P<0.05).结论 手法复位小夹板固定治疗骨折疏松型桡骨远端骨折有利于患者骨折的恢复,能够更快的减轻患者疼痛,缩短恢复时间,且对骨密度影响较小,值得推广.

Effects of manipulative reduction and splint fixation in the treatment of osteoporotic distal radius fractures

Objective To discuss the clinical effects of manipulative reduction and splint fixation in the treat-ment of osteoporotic distal radius fractures. Methods A total of 98 patients with osteoporotic distal radius fractures from Department of Orthopedics from Foshan Hospital of TCM from February 2012 to June 2015 were randomly divid-ed into the observation group (n=49) and the control group (n=49) by random number table, the observation group was treated with manipulative reduction and splint fixation, while the control group was treated with open reduction and inter-nal fixation. Then excellent rate of the wrist score, bone density, palmar tilt, ulnar deviation, hand swelling time, pain re-lief time, fracture healing time were contrasted between the two groups. Results The excellent rate of the wrist score in the observation group was 85.7%, which was significantly higher than 69.4%in the control group (P<0.05). There was no significant difference in bone density before the treatment between the observation group (-2.588±0.089) and the con-trol group (-2.562±0.085) (P>0.05), but after treatment, the bone density of observation group (-2.601±0.083) was sig-nificantly higher than that of the control group (-2.978±0.085) (P<0.01). Before treatment, the palmar tilt in the observa-tion group and the control group were (4.63±1.42)° and (4.56±1.50)° respectively, and the ulnar deviation were (15.21± 2.83)° and (15.48 ± 2.85)° respectively, with no significant difference between the two groups (P>0.05). After treatment, the palmar tilt in the observation group and the control group were (7.99 ± 1.44)° and (7.92 ± 1.48)° respectively, and the ulnar deviation were (19.29±2.88)° and (19.24±2.91)° respectively, which were all significantly larger than those before treatment (P<0.05), with no significant difference between two groups after the treatment (P>0.05). Hand swelling time, pain relief time, fracture healing time in the observation group were (6.3±1.7) d, (3.3±0.9) d, and (34.1±8.9) d respective-ly, significantly shorter than (9.8±2.1) d, (4.9±0.8) d, and (45.1±9.3) d in the control group, and the difference was statis-tically significant (P<0.01). Conclusion Manipulative reduction and splint fixation is advantageous to the recovery of fractures in the treatment of osteoporotic distal radius fractures. It can reduce the pain faster, shorten the recovery time, and has little effect on bone mineral density, which is worthy of promotion.