手法整复对桡骨远端骨折伴神经损伤的疗效

目的探究手术联合手法整复对老年桡骨远端骨折伴正中神经损伤患者功能恢复及预后的影响,为临床选择治疗方案提供参考依据。方法选择2016-10—2019-01在义马煤业集团股份有限责任公司总医院治疗的老年桡骨远端骨折伴正中神经损伤患者68例为研究对象。按照随机数表法,将68例患者随机分为对照组和研究组,每组34例。对照组仅使用手法整复进行治疗,研究组使用手术联合手法整复进行治疗。3个月后,比较2组患者的腕关节功能恢复情况以及预后情况。结果3个月后,研究组屈伸活动、旋前、旋后、桡偏、尺偏、握力等功能恢复程度分别为(87.43±5.56)°、(82.74±5.76)°、(80.58±4.14)°、(18.09±4.48)°、(25.76±4.29)°、(86.05±5.47)%,显著优于对照组的(78.75±5.28)°、(71.98±5.24)°、(68.89±4.46)°、(12.50±4.59)°、(21.48±4.02)°、(77.85±5.25)%,差异有统计学意义(P<0.05);研究组腕关节功能Gartland-Werley评分优良率(85.29%)显著高于对照组(73.53%),差异有统计学意义(P<0.05);研究组疼痛、两点辨别觉、大鱼际肌力、生活自理能力等疗效评分分别为(5.64±1.27)分、(9.03±0.75)分、(9.61±0.12)分、(62.67±5.56)分,显著高于对照组(3.05±0.81、7.45±0.42、8.02±0.32、58.59±5.79)分,差异有统计学意义(P<0.05);研究组预后不良率(14.71%)明显低于对照组(32.35%),比较差异有统计学意义(P<0.05)。结论应用手术联合手法整复治疗老年桡骨远端骨折伴正中神经损伤,患者腕关节功能恢复效果明显,预后效果良好,值得推广。

Efficacy of manual reconstruction on distal radius fracture with nerve injury

Objective To explore the effect of operation combined with manual reduction on functional recovery and prognosis of elderly patients with distal radius fracture and median nerve injury,and to provide reference for clinical treatment.Methods 68 elderly patients with distal radius fracture and median nerve injury treated in our hospital from October 2016 to January 2019 were selected as subjects of study.According to the random number table method,68 patients were randomly divided into control group and research group,34 cases in each group.The control group was treated with manual reduction only,while the research group was treated with surgery combined with manual reduction.Three months later,wrist function recovery and prognosis were compared between the two groups.Results After three months,the functional recovery of flexion and extension,pronation,supination,radial deviation,ulnar deviation and grip strength in the study group were(87.43±5.56)°,(82.74±5.76)°,(80.58±4.14)°,(18.09±4.48)°,(25.76±4.29)°,(86.05±5.47)%,respectively,which were significantly better than those in the control group(78.75±5.28)°,(71.98±5.24)°,(68.89±4.46)°,(12.50±4.59)°,(21.48±4.02)°,(77.85±5.25)%,and the difference was significant(P<0.05).The excellent and good rate of Gartland-Werley score of wrist joint function in the study group(85.29%)was significantly higher than that in the control group(73.53%)(P<0.05).The scores of pain,two-point discrimination,thenar muscle strength and self-care ability in the study group were as follows5.64±1.27,9.03±0.75,9.61±0.12,62.67±5.56 scores,which Significantly higher than the control group(3.05±0.81,7.45±0.42,8.02±0.32,58.59±5.79)scores,and the difference was significant(P<0.05).The poor prognosis rate(14.71%)in the study group was significantly lower than that in the control group(32.35%)with statistical significance(P<0.05).Conclusion Operation combined with manipulative reduction in the treatment of distal radius fracture with median nerve injury in elderly patients has obvious effect on wrist joint function recovery and good prognosis,which is worthy of promotion.