Millett P J, Rushton N
Orthopaedic Research Unit, University of Cambridge, UK.
Injury. 1995 Dec;26(10):671-5. doi: 10.1016/0020-1383(95)00146-8.
Ninety consecutive women with unilateral Colles' fractures were randomized into two different treatment groups. The control group was treated for 5 weeks in conventional short-arm, below the elbow plaster of Paris casts. The other group (N = 45) was treated similarly in plaster casts for 3 weeks and then had flexible casting applied for the remaining 2 weeks which allowed for early joint mobilization. Functional recovery was assessed by measuring grip strength and joint mobility at intervals over the 3 years. Radiographic and overall assessments were also made during 3 year course of study. Virtually all patients reported greater comfort after switching to the flexible casting. Mean grip scores and joint mobilities were higher at all time points with early mobilization, reaching levels of statistical significance at 6 months for grip score and at 3 months for joint mobility. By 3 years most differences between treatment groups had resolved. We found no evidence that early mobilization was detrimental to recovery. We conclude that early mobilization is a satisfactory treatment option for Colles' fracture, and may, in fact, hasten functional recovery.
90例单侧Colles骨折的连续女性患者被随机分为两个不同的治疗组。对照组采用传统的短臂肘下巴黎石膏固定治疗5周。另一组（n = 45）同样采用石膏固定治疗3周，然后在剩余2周采用可灵活固定的石膏，以便早期进行关节活动。通过在3年期间定期测量握力和关节活动度来评估功能恢复情况。在3年的研究过程中还进行了影像学和总体评估。几乎所有患者在改用可灵活固定的石膏后都表示舒适度更高。早期活动组在所有时间点的平均握力评分和关节活动度均更高，握力评分在6个月时、关节活动度在3个月时达到统计学显著水平。到3年时，治疗组之间的大多数差异已消除。我们没有发现早期活动对恢复有害的证据。我们得出结论，早期活动是Colles骨折令人满意的治疗选择，实际上可能会加速功能恢复。
