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闭合复位后夹板与石膏联合固定治疗老年桡骨远端骨折

[The combined fixation with splints and plaster after closed reduction for the treatment of distal fractures of radius in elderly patients].

作者信息

Ma Xu-wei, Zhao Ying-huan, Shi Jing-chao, Liu Zheng-yi, Qian Lie-min, Li Ming, Chi Hui-zhen

机构信息

Department of Orthopaedics, Traditional Chinese Medicine of Xiangshan County, Xiangshan 315700, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2011 Nov;24(11):904-6.

Abstract

OBJECTIVE

To evaluate the effects of combined fixation with splints and plaster after closed reduction for the treatment of distal fractures of radius in elderly patients

METHODS

From January 2009 to January 2011, 122 patients with distal fractures of radius were treated by the united fixation with splints and plaster after closed reduction. There were 43 males and 79 females, ranging in age from 60 to 86 years with an average of 74 years. Among the patients, traffic accident injury was in 12 cases and fall injury was in 109 cases; all fractures were closed, the time form injury to visit was for 30 min to 7 days. The X-rays, wrist pain, functional status, range of motion and grasp force of patients were observed at follow-up. Cooney modified Green-O'Brien standard was used to evaluate the clinical effects.

RESULTS

All the patients were followed up from 3 months to 2 years with an average of 15.4 months. Re-displacement occurred in 8 cases (including 4 cases radial displacement, 3 cases dorsal displacement, 1 case palmaris displacement) and re-reduction occurred in 4 cases, surgical treatment was in 2 cases, refused to reset or surgical treatment in 2 cases. Radial shorten in 13 cases middle-later period. All fractures obtained healed. According to the Green-O'Brien standard, 46 cases got excellent results, 65 good, 6 fair, and 5 poor.

CONCLUSION

The combined fixation with splints and plaster after closed reduction is a effective method in treatment of distal fractures of radius in elderly patients, which can more overcome redisplacement of distal fractures of radius, recover function of wrist joint.

摘要

目的

评估闭合复位后夹板与石膏联合固定治疗老年桡骨远端骨折的效果。

方法

2009年1月至2011年1月,对122例桡骨远端骨折患者采用闭合复位后夹板与石膏联合固定治疗。其中男性43例,女性79例,年龄60~86岁,平均74岁。患者中,交通事故伤12例,跌倒伤109例;均为闭合性骨折,受伤至就诊时间为30分钟至7天。随访时观察患者的X线表现、腕部疼痛、功能状态、活动范围及握力。采用Cooney改良的Green-O'Brien标准评估临床效果。

结果

所有患者随访3个月至2年,平均15.4个月。8例出现再移位(其中桡侧移位4例,背侧移位3例,掌侧移位1例),4例进行了再次复位,2例接受了手术治疗,2例拒绝复位或手术治疗。13例中后期出现桡骨短缩。所有骨折均愈合。根据Green-O'Brien标准,优46例,良65例,可6例,差5例。

结论

闭合复位后夹板与石膏联合固定是治疗老年桡骨远端骨折的有效方法,能较好地克服桡骨远端骨折的再移位,恢复腕关节功能。

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