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超肘关节夹板与传统小夹板固定治疗Colles骨折疗效比较

[Comparison of the curative effect between over-elbow splint and traditional small splint fixation in the treatment of comminuted Colles fracture].

作者信息

Chen Min, Li Teng-Hui, Huang Guang-Ping, Liu Hui

机构信息

Guangdong Provincial People Hospital, Guangzhou 510080, Guangdong, China;

Guangdong Provincial People Hospital, Guangzhou 510080, Guangdong, China.

出版信息

Zhongguo Gu Shang. 2017 Mar 25;30(3):222-226. doi: 10.3969/j.issn.1003-0034.2017.03.007.

Abstract

OBJECTIVE

To analyze the clinical efficacy of over-elbow small splint fixation for the treatment of comminuted Colles fractures.

METHODS

From October 2013 to October 2015, 52 patients with comminuted Colles fracture were divided into two groups (the traditional splint fixation group and the over-elbow small splint fixation group) according to the treatment strategy. There were 26 patients in the over-elbow small splint fixation group including 7 males and 19 females with an average age of (64.615±11.475) years old ranging from 38 to 85 years old, and 26 patients in the traditional splint fixation group including 9 males and 17 females with an average age of (65.269±13.162) years old ranging 36 to 91 years old, respectively. In the over-elbow small splint fixation group, 3 cases were type A3 fractures, 9 cases were type C1, 7 cases were type C2 and 7 cases were type C3;in the traditional splint fixation group, 4 cases were type A3, 8 cases were type C1, 9 cases were type C2 and 5 cases were type C3. After manipulative reduction, the fractures in traditional splint fixation group were fixed with traditional small splint, and the fractures in over-elbow small splint fixation group were added with over-elbow right angle splint for the first three weeks, then continued fixing like the control group until clinical cicatrization. All patients in both groups were regularly taken X-ray examination and changed dressings to obtain the clinical healing. Patients were guided to do functional exercise after splints were taken off. The therapeutic effects were evaluated according to modified Green and O'Brein score system after 8 weeks' functional exercise.

RESULTS

All patients got clinical healing without severe complications in both groups. The shortened length of radius in traditional splint fixation group was more than that in over-elbow small splint fixation group (5.923±1.978) mm VS (2.962±1.248) mm(<0.05). There was no significant difference in radial incline between two groups. There was a higher wrist score in over-elbow small splint fixation group compared with traditional splint fixation group 89.615±11.482 vs 80.385±13.485(<0.05).

CONCLUSIONS

Over-elbow small splint fixation is better than traditional splint fixation for the treatment of comminuted Colles fracture because of reliable clinical result and excellent wrist functional recovery.

摘要

目的

分析超肘小夹板固定治疗粉碎性Colles骨折的临床疗效。

方法

选取2013年10月至2015年10月收治的52例粉碎性Colles骨折患者,根据治疗方法分为两组(传统夹板固定组和超肘小夹板固定组)。超肘小夹板固定组26例,男7例,女19例,平均年龄(64.615±11.475)岁,年龄范围38~85岁;传统夹板固定组26例,男9例,女17例,平均年龄(65.269±13.162)岁,年龄范围36~91岁。超肘小夹板固定组中,A3型骨折3例,C1型9例,C2型7例,C3型7例;传统夹板固定组中,A3型骨折4例,C1型8例,C2型9例,C3型5例。手法复位后,传统夹板固定组采用传统小夹板固定,超肘小夹板固定组在前3周加用超肘直角夹板固定,之后同对照组继续固定至临床愈合。两组患者均定期行X线检查及换药,直至临床愈合。拆除夹板后指导患者进行功能锻炼。功能锻炼8周后,根据改良Green和O'Brien评分系统评估疗效。

结果

两组患者均临床愈合且无严重并发症发生。传统夹板固定组桡骨短缩长度大于超肘小夹板固定组(5.923±1.978)mm比(2.962±1.248)mm(<0.05)。两组桡骨倾斜度比较差异无统计学意义。超肘小夹板固定组腕关节评分高于传统夹板固定组89.615±11.482比80.385±13.485(<0.05)。

结论

超肘小夹板固定治疗粉碎性Colles骨折临床效果可靠,腕关节功能恢复良好,优于传统夹板固定。

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