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闭合复位联合夹板固定治疗儿童桡尺骨远端移位骨折的临床观察

Clinical observation on the treatment of displaced distal radial and ulnar fractures in children by closed manipulation combined with splinting.

作者信息

Wang Guangwei, Huo Liwei, Xu Yidong, Dai Gerong, Yang Zhong, Hu Jianwei, Liu Weinian

机构信息

Department of Orthopaedics, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.

Department of Orthopaedics, Guangzhou Orthopedic Hospital, Guangzhou, China.

出版信息

Front Surg. 2023 Sep 19;10:1199437. doi: 10.3389/fsurg.2023.1199437. eCollection 2023.

Abstract

OBJECTIVE

The aim of this study was to investigate the clinical efficacy of closed manipulation combined with splinting in the treatment of displaced distal radial and ulnar fractures in children.

METHODS

A total of 82 children with displaced fractures of the distal radial and ulnar segment who met the inclusion criteria and were treated as outpatients or inpatients in the orthopedic department of Guangzhou Orthopedic Hospital, from January 2016 to June 2022 were randomly divided into an observation group and a control group: 41 children in the observation group were treated with closed manipulation combined with splint fixation; 41 children in the control group were fixed with incisional repositioning elastic nails combined with internal plates. The Anderson efficacy grading, visual analog scale (VAS) score, fracture healing time, treatment cost, hospital days, and complications were observed and compared between the two groups.

RESULT

The efficacy was evaluated according to the Anderson forearm fracture efficacy evaluation criteria, and the results of statistical analysis showed no statistically significant differences between the two groups (> 0.05). At 3 and 7 weeks after treatment, the VAS scores of children in both groups decreased (< 0.05), and the VAS scores in the observation group were significantly lower than those in the control group (< 0.05), indicating that the observation group had a significant advantage in the relief of pain after treatment. The fractures healed in both groups after treatment with the two different methods, and the difference in healing time between the two groups was not statistically significant ( > 0.05). The length of hospital stay, treatment cost, and complication ratio were significantly lower in the observation group than in the control group ( < 0.05).

CONCLUSION

In children with displaced fractures of the distal radial and ulnar segments, treatment by manual repositioning with external splinting can achieve satisfactory results with simple operation, low cost, short hospital stay, and few complications, which is especially suitable to be promoted in primary hospitals and has good social benefits.

摘要

目的

本研究旨在探讨闭合手法复位联合夹板固定治疗儿童桡尺骨远端移位骨折的临床疗效。

方法

选取2016年1月至2022年6月在广州市正骨医院骨科门诊或住院治疗、符合纳入标准的82例桡尺骨远端移位骨折患儿,随机分为观察组和对照组:观察组41例采用闭合手法复位联合夹板固定治疗;对照组41例采用切开复位弹性髓内钉联合钢板内固定治疗。观察比较两组患儿的Anderson疗效分级、视觉模拟评分(VAS)、骨折愈合时间、治疗费用、住院天数及并发症情况。

结果

依据Anderson前臂骨折疗效评价标准进行疗效评估,统计分析结果显示两组间差异无统计学意义(P>0.05)。治疗后3周和7周,两组患儿的VAS评分均降低(P<0.05),且观察组VAS评分显著低于对照组(P<0.05),表明观察组治疗后疼痛缓解方面具有显著优势。两组采用不同方法治疗后骨折均愈合,两组愈合时间差异无统计学意义(P>0.05)。观察组住院时间、治疗费用及并发症发生率均显著低于对照组(P<0.05)。

结论

对于桡尺骨远端移位骨折患儿,手法复位外固定夹板治疗操作简便、费用低、住院时间短、并发症少,疗效满意,尤其适合在基层医院推广,具有良好的社会效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09b5/10546061/194d9bdbba86/fsurg-10-1199437-g001.jpg

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