摘要
【目的】探讨手法牵引复位、石膏夹板固定治疗桡骨远端骨折的操作方法及其疗效。【方法】140例桡骨远端骨折病人采用手法持续牵引复住，伸直尺偏位前后石膏夹板固定。骨折愈合后测量腕关节活动度和握力，改良Gteen和O＇Brien临床评分系统评价关节功能。腕关节正侧位片进行测量桡骨长度、桡骨倾斜角、掌倾角、桡尺骨指数及关节间隙宽度。【结果】140例中，一次复位成功者109例，31例复位二次。102例腕关节无疼痛，34例偶尔有轻度疼痛，4例中度疼痛。患侧腕关节活动度及握力达到健侧100％者12例／52例，75％～99％者124例／78例，50％～70％者4例／10例；改良Gteen和O/Brien评分优71例，良56例，可13例。最终桡骨短缩、桡骨倾斜角、掌倾角、桡尺骨指数明显纠正，与复位前比较有显著性差异（P均〈0．05）。【结论】手法牵引复位石膏夹板固定是治疗桡骨远端骨折的一种安全有效的方法，有利于腕关节功能恢复。
[Objective]To evaluate clinical efficacy of manual reduction under traction and plastic sphnt fixation in the treatment of distal radius fracture. [Methods]A total of 140 cases with distal radius fracture were treated by manual reduction under continual traction and fixed with anteroposterior plastic splints in the posi- tion of straight and ulnar leaning. The motive range of wrist and grip force was measured after fusion, and the joint function was assessed by Green and O＇Brien modified score system. Radiographs were taken in order to evaluate the length of radius, tilt angle of radius, palmar tilt angle, ulnar variance and the width of joint. [Resuits]In all 140 cases, 109 cases acquired success reduction once for all and 31 cases acquired reduction for two times. And 102 patients had no wrist pain, 34 patients had occasionally mild pain, 4 patients had pain. There were 12 patients with motive ranges of injured wrist reached up to 100% of intact wrist, 78 cases with 75 %- 99 %, and 4 cases with 50%-70%. According to Green and O＇Brien modified score system, 71 patients were excellent, 56 good, and 13 fair. The length of radius, tilt angle of radius, palmar tilt angle and ulnar variance were corrected obviously, and the difference was significant （ P 〈0.05）. [Conclusion]Manual traction and plastic splints fixation is a safe and effective method in the treatment of distal radius fractures, and it is helpful for recovery of wrist function.
出处
《医学临床研究》
CAS
2008年第7期1180-1183,共4页
Journal of Clinical Research
