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儿童手指骨折的同伴包扎与夹板固定:一项随机对照试验

Buddy taping versus splint immobilization for paediatric finger fractures: a randomized controlled trial.

作者信息

Weber Daniel M, Seiler Michelle, Subotic Ulrike, Kalisch Markus, Weil Robert

机构信息

1 Division of Hand Surgery, University Children's Hospital, Zurich, Switzerland.

2 Children's Research Center, University Children's Hospital, Zurich, Switzerland.

出版信息

J Hand Surg Eur Vol. 2019 Jul;44(6):640-647. doi: 10.1177/1753193418822692. Epub 2019 Jan 31.

Abstract

The purpose of this single-centre randomized controlled trial was to assess the non-inferiority of buddy taping versus splint immobilization of extra-articular paediatric finger fractures. Secondary fracture displacement was the primary outcome; patient comfort, cost and range of finger motion were secondary outcomes. Ninety-nine children were randomly assigned to taping or splinting. Sixty-nine fractures were undisplaced; 31 were displaced and required reduction before taping or splinting. Secondary displacement occurred in one patient in the taping and three in the splinting group. The risk difference was below the predefined non-inferiority level of 5%. All secondary displacements occurred in the 31 displaced fractures after reduction and were in little fingers. Patient comfort was significantly higher and cost lower in the taping group. We conclude from this study the non-inferiority of buddy taping versus splint immobilization of extra-articular paediatric finger fractures in general. We advise treatment may need to be individualized for patients with displaced fractures because we cannot make any absolute conclusions for these fractures. I.

摘要

这项单中心随机对照试验的目的是评估儿童关节外手指骨折采用搭胶带法与夹板固定法的非劣效性。二次骨折移位是主要结局;患者舒适度、成本和手指活动范围是次要结局。99名儿童被随机分配至胶带固定组或夹板固定组。69处骨折无移位;31处骨折有移位,在进行胶带固定或夹板固定前需要复位。胶带固定组有1例患者发生二次移位,夹板固定组有3例。风险差异低于预先设定的5%的非劣效性水平。所有二次移位均发生在31处复位后的移位骨折中,且均位于小指。胶带固定组患者舒适度显著更高,成本更低。我们从本研究得出结论,一般而言,儿童关节外手指骨折采用搭胶带法与夹板固定法具有非劣效性。对于移位骨折患者可能需要个体化治疗,因为我们无法对这些骨折得出任何绝对结论。I.

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