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评估手法复位和新型牵引技术治疗桡骨远端骨折的疗效:一项随机对照试验。

Assessing the efficacy of manual reduction and novel traction techniques for distal radius fractures: A randomized controlled trial.

作者信息

Majidi Morteza, Rohani Erfan, Chamani Vahid, Rezaei Mehdi, Roostayi Mohammad Mohsen, Ghaznavi Alireza, Khosravi Mobina

机构信息

Medicine School Hamedan University of Medical Sciences Hamedan Iran.

Department of Orthotics and Prosthetics University of Social Welfare and Rehabilitation Sciences Tehran Iran.

出版信息

Health Sci Rep. 2024 Jul 1;7(7):e2227. doi: 10.1002/hsr2.2227. eCollection 2024 Jul.

Abstract

BACKGROUND AND AIM

One of the leading reasons that patients, particularly older persons, are brought to the orthopedic emergency room is a fracture at the end of the radius. In this study, a new traction method for distal radius fractures was compared with manual reduction.

METHODS

The census method was used in this clinical trial to study 45 patients (46 hands) who were referred to Hamedan Besat Hospital in 2021. Patients were randomly assigned to two groups. The manual reduction (pressure and traction by an assistant and a doctor) method was implemented in Group A, and the new traction procedure (pressure and traction by hardware or a device) was performed in Group B. The radiographic results of reduction in both groups were investigated and compared immediately and in the first and 6 weeks after surgery.

RESULTS

The following results were observed in the new and manual groups in the sixth week after surgery: average volar tilt: 4.19 ± 3.79 and 4.08 ± 3.88 ( = 0.926), radial angulation: 2.18 ± 1.27 and 2.21 ± 1.35 ( = 0.934), radial shortening: 10.52 ± 0.65 and 10.56 ± 0.68 ( = 0.828), radial inclination: 22.52 ± 2.46 and 22.71 ± 2.01 ( = 0.787), dorsal angulation: -5.89 ± 0.33 and 5.22 ± -1.91 ( = 1.00), ulnar variance: 1.66 ± 0.90 and 1.67 ± 0.81 ( = 0.958), and average pain score: 2.40 ± 0.68 and 2.47 ± 0.73 ( = 0.737).

CONCLUSION

The new reduction procedure with hardware in patients with distal radius fractures showed the same effect as the traditional method based on pressure and traction by the assistant and doctor in terms of radiographic changes and pain score of the fracture site.

摘要

背景与目的

患者,尤其是老年人,被送往骨科急诊室的主要原因之一是桡骨远端骨折。在本研究中,将一种新的桡骨远端骨折牵引方法与手法复位进行了比较。

方法

本临床试验采用普查法,研究了2021年转诊至哈马丹贝萨特医院的45例患者(46只手)。患者被随机分为两组。A组采用手法复位(由助手和医生进行按压和牵引)方法,B组采用新的牵引程序(通过硬件或器械进行按压和牵引)。对两组复位后的影像学结果在术后即刻、术后第1周和第6周进行了调查和比较。

结果

术后第6周,新方法组和手法复位组观察到以下结果:平均掌倾角:4.19±3.79和4.08±3.88(P=0.926),桡偏角:2.18±1.27和2.21±1.35(P=0.934),桡骨短缩:10.52±0.65和10.56±0.68(P=0.828),桡骨倾斜角:22.52±2.46和22.71±2.01(P=0.787),背倾角:-5.89±0.33和5.22±-1.91(P=1.00),尺骨变异:1.66±0.90和1.67±0.81(P=0.958),平均疼痛评分:2.40±0.68和2.47±0.73(P=0.737)。

结论

在桡骨远端骨折患者中,基于硬件的新复位程序在骨折部位的影像学变化和疼痛评分方面与传统的由助手和医生进行按压和牵引的方法效果相同。

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