目的:比较小夹板外固定对3种类型Colles骨折的固定效果。方法:回顾性分析62例采用手法复位小夹板外固定治疗的Colles骨折患者的病例资料;按AO分型标准,A型9例(A型组)、B型28例(B型组)、C型25例(C型组)。所有患者均按照《中医骨伤科常见...目的:比较小夹板外固定对3种类型Colles骨折的固定效果。方法:回顾性分析62例采用手法复位小夹板外固定治疗的Colles骨折患者的病例资料;按AO分型标准,A型9例(A型组)、B型28例(B型组)、C型25例(C型组)。所有患者均按照《中医骨伤科常见病诊疗指南》中桡骨远端骨折的操作规范进行手法复位小夹板外固定。根据X线片评估骨折愈合情况,测量桡骨高度、掌倾角及尺偏角,并采用Green and O’Brien腕关节评分标准评定腕关节功能。比较治疗后6周时3组患者的桡骨高度、掌倾角、尺偏角的恢复情况及治疗后12个月时的腕关节功能。结果:所有患者均未发生骨折再移位。所有骨折均获骨性愈合;3组患者的骨折愈合时间比较,差异无统计学意义[(5.9±2.9)周,(6.1±2.4)周,(6.1±1.9)周,F=3.201,P=0.089]。治疗后6周时,3组患者的掌倾角增加值比较,差异无统计学意义(12.64°±1.53°,14.08°±3.09°,14.03°±2.79°,F=2.166,P=0.121);3组患者的桡骨高度增加值比较,差异有统计学意义[(0.97±0.17)cm,(0.83±0.19)cm,(0.63±0.16)cm,F=9.473,P=0.021],A型组桡骨高度增加值大于B型组和C型组(P=0.030;P=0.002),B型组大于C型组(P=0.001);3组患者的尺偏角增加值比较,差异有统计学意义(15.60°±1.75°,16.57°±1.86°,13.76°±1.94°,F=11.483,P=0.001),A型组和B型组尺偏角增加值均大于C型组(P=0.001;P=0.029),A型组和B型组比较,差异无统计学意义(P=0.078)。治疗后12个月时3组患者的Green and O’Brien评分比较,差异有统计学意义[(88.56±2.19)分,(81.79±4.74)分,(69.68±6.01)分,F=13.619,P=0.000],A型组的评分高于B型组和C型组(P=0.011;P=0.000),B型组评分高于C型组(P=0.001)。结论:对于A、B型Colles骨折,小夹板外固定可有效维持复位后骨折端的稳定,有利于关节功能恢复;但对于C型Colles骨折,小夹板外固定效果较差。展开更多
目的：探讨Colles骨折手法复位质量与腕关节功能恢复之间的关系。方法：将Colles骨折患者120例通过Frykman分型制定手术或非手术治疗方案并进行干预后,随访4~20月,通过影像学方法记录治疗前后患者桡骨短缩距离、关节内骨折移位及掌倾角...目的：探讨Colles骨折手法复位质量与腕关节功能恢复之间的关系。方法：将Colles骨折患者120例通过Frykman分型制定手术或非手术治疗方案并进行干预后,随访4~20月,通过影像学方法记录治疗前后患者桡骨短缩距离、关节内骨折移位及掌倾角、尺偏角;应用Lidstrom评分系统进行解剖评分,采用Garland and Werley腕关节评分系统进行腕关节功能评分,比较2种评价标准的优良率。结果：干预后患者桡骨短缩距离为（1.62±0.34）mm,关节内骨折移位为（0.72±0.05）mm,掌倾角丢失为（0.69±3.45）°,尺偏角丢失为（6.32±2.87）°时腕关节功能恢复最佳,低于桡骨短缩距离5mm,关节内骨折移位2mm,尺偏角丢失3°,掌倾角丢失9°的传统评价标准;Garland and Werley评价显示优良率为92.5%,与Lidstrom评价的优良率94.17%相当（P〉0.05）。结论：桡骨远端骨折手法复位质量越高,则腕关节功能恢复越佳;但治疗过程中不强求绝对的解剖复位,要尽量达到关节面平整、桡骨短缩小于（2.89±0.87）mm、关节内骨折移位小于（1.72±0.56）mm、掌倾角丢失小于（8.78±3.63）°、尺偏角丢失小于（10.66±3.13）°的复位标准,腕关节功能恢复为优良,较传统评价标准的适用范围广。展开更多
目的探讨外固定架(external fixation,EF)与切开复位内固定(open reduction internal fixation,ORIF)治疗不稳定性桡骨远端骨折的疗效。方法对术后的关节活动度(range of motion,ROM)及握力、影像学结果、上肢功能评分(disabilities of ...目的探讨外固定架(external fixation,EF)与切开复位内固定(open reduction internal fixation,ORIF)治疗不稳定性桡骨远端骨折的疗效。方法对术后的关节活动度(range of motion,ROM)及握力、影像学结果、上肢功能评分(disabilities of the arm,shoulder and hand scores,DASH评分)、再手术率及并发症进行Meta分析。计算机检索Medline、Embase、Cochrane Library、PubMed、维普资讯、中文科技期刊全文数据库和中国万方数据库等中英文数据库,手工检索国内相关杂志9种,均从创刊检索至2013年3月,搜集不稳定性桡骨远端骨折的内固定或外固定治疗的临床研究。纳入符合标准的文献,提取相关数据输入Review Manager 5.0软件进行Meta分析。结果共12篇文献符合。纳入标准,经改良Jadad评分均判定为高质量研究。纳入病例920例。在术后3个月时,EF组仅有前臂旋前角度优于ORIF组(open reduction internal fixation,ORIF)(MD 5.13,95%CI[2.04,8.22],P=0.001),ORIF组的掌屈(MD=-6.15,95%CI[-9.65,-2.65],P=0.0006)、背伸(MD=-11.12,95%CI[-16.59,-5.66],P<0.0001)、尺偏角(MD=-2.70,95%CI[-4.94,-0.46],P=0.02)、旋后(MD=-11.56,95%CI[-16.28,-6.84],P<0.00001)以及握力恢复(MD=-12.82,95%CI[-20.24,-5.41],P=0.0007)均优于EF组。但两组术后6个月及1年ROM和握力恢复的效果相同。ORIF组在术后3个月和1年时均有较好的DASH评分(3个月时DASH评分MD=15.54,95%CI[8.77,22.32],P<0.00001;12个月时DASH评分MD=3.14,95%CI[0.20,6.07],P=0.04)。此外,ORIF组更好地恢复掌倾角(MD=-1.95,95%CI[-3.18,-0.72],P=0.002)及尺骨方差(MD=0.60,95%CI[0.12,1.07],P=0.01),并同时降低了并发症的发生率(MD=1.63,95%CI[1.16,2.28],P=0.005)。两组间在桡倾角、桡骨高度、再手术率,感染以外的并发症发生率差异无统计学意义。结论 ORIF治疗不稳定桡骨远端骨折,术后患者可早期恢复握力并具有较好腕关节活动度,在术后较长时间内有较好的DASH评分,能更好地恢复尺骨方差和掌倾角同�展开更多
Background: Colles’ fracture is a type of fracture of the distal third of the radius and its most common cause is falling from patient’s own height and, epidemiologically, it is more common in the elderly. Objective...Background: Colles’ fracture is a type of fracture of the distal third of the radius and its most common cause is falling from patient’s own height and, epidemiologically, it is more common in the elderly. Objectives: The main objective of this study is to analyze the epidemiology of Colles’ fracture retrospectively, in patients admitted to Fernandes Távora Hospital. Materials and Methods: This retrospective study conducted at the Fernandes Távora Hospital used 1030 radiographic images of patients with wrist fractures. Results: (After a careful analysis) It was found that this type of fracture occurred with a greater frequency in age groups of 50 to 69, 60 to 69, and 40 to 49 years old, which corresponds to 59.5% of patients and the most affected sex were females (51.1%). Conclusion: The study concluded that this type of bone injury is more common in people aged 40 to 69 years old, especially in women, because of their geometry and bone composition. It is evident that Colles’ fracture impacts the life of the affected person, therefore, an adequate diagnosis and treatment having utmost importance.展开更多
文摘目的:比较小夹板外固定对3种类型Colles骨折的固定效果。方法:回顾性分析62例采用手法复位小夹板外固定治疗的Colles骨折患者的病例资料;按AO分型标准,A型9例(A型组)、B型28例(B型组)、C型25例(C型组)。所有患者均按照《中医骨伤科常见病诊疗指南》中桡骨远端骨折的操作规范进行手法复位小夹板外固定。根据X线片评估骨折愈合情况,测量桡骨高度、掌倾角及尺偏角,并采用Green and O’Brien腕关节评分标准评定腕关节功能。比较治疗后6周时3组患者的桡骨高度、掌倾角、尺偏角的恢复情况及治疗后12个月时的腕关节功能。结果:所有患者均未发生骨折再移位。所有骨折均获骨性愈合;3组患者的骨折愈合时间比较,差异无统计学意义[(5.9±2.9)周,(6.1±2.4)周,(6.1±1.9)周,F=3.201,P=0.089]。治疗后6周时,3组患者的掌倾角增加值比较,差异无统计学意义(12.64°±1.53°,14.08°±3.09°,14.03°±2.79°,F=2.166,P=0.121);3组患者的桡骨高度增加值比较,差异有统计学意义[(0.97±0.17)cm,(0.83±0.19)cm,(0.63±0.16)cm,F=9.473,P=0.021],A型组桡骨高度增加值大于B型组和C型组(P=0.030;P=0.002),B型组大于C型组(P=0.001);3组患者的尺偏角增加值比较,差异有统计学意义(15.60°±1.75°,16.57°±1.86°,13.76°±1.94°,F=11.483,P=0.001),A型组和B型组尺偏角增加值均大于C型组(P=0.001;P=0.029),A型组和B型组比较,差异无统计学意义(P=0.078)。治疗后12个月时3组患者的Green and O’Brien评分比较,差异有统计学意义[(88.56±2.19)分,(81.79±4.74)分,(69.68±6.01)分,F=13.619,P=0.000],A型组的评分高于B型组和C型组(P=0.011;P=0.000),B型组评分高于C型组(P=0.001)。结论:对于A、B型Colles骨折,小夹板外固定可有效维持复位后骨折端的稳定,有利于关节功能恢复;但对于C型Colles骨折,小夹板外固定效果较差。
文摘目的：探讨Colles骨折手法复位质量与腕关节功能恢复之间的关系。方法：将Colles骨折患者120例通过Frykman分型制定手术或非手术治疗方案并进行干预后,随访4~20月,通过影像学方法记录治疗前后患者桡骨短缩距离、关节内骨折移位及掌倾角、尺偏角;应用Lidstrom评分系统进行解剖评分,采用Garland and Werley腕关节评分系统进行腕关节功能评分,比较2种评价标准的优良率。结果：干预后患者桡骨短缩距离为（1.62±0.34）mm,关节内骨折移位为（0.72±0.05）mm,掌倾角丢失为（0.69±3.45）°,尺偏角丢失为（6.32±2.87）°时腕关节功能恢复最佳,低于桡骨短缩距离5mm,关节内骨折移位2mm,尺偏角丢失3°,掌倾角丢失9°的传统评价标准;Garland and Werley评价显示优良率为92.5%,与Lidstrom评价的优良率94.17%相当（P〉0.05）。结论：桡骨远端骨折手法复位质量越高,则腕关节功能恢复越佳;但治疗过程中不强求绝对的解剖复位,要尽量达到关节面平整、桡骨短缩小于（2.89±0.87）mm、关节内骨折移位小于（1.72±0.56）mm、掌倾角丢失小于（8.78±3.63）°、尺偏角丢失小于（10.66±3.13）°的复位标准,腕关节功能恢复为优良,较传统评价标准的适用范围广。
文摘目的探讨外固定架(external fixation,EF)与切开复位内固定(open reduction internal fixation,ORIF)治疗不稳定性桡骨远端骨折的疗效。方法对术后的关节活动度(range of motion,ROM)及握力、影像学结果、上肢功能评分(disabilities of the arm,shoulder and hand scores,DASH评分)、再手术率及并发症进行Meta分析。计算机检索Medline、Embase、Cochrane Library、PubMed、维普资讯、中文科技期刊全文数据库和中国万方数据库等中英文数据库,手工检索国内相关杂志9种,均从创刊检索至2013年3月,搜集不稳定性桡骨远端骨折的内固定或外固定治疗的临床研究。纳入符合标准的文献,提取相关数据输入Review Manager 5.0软件进行Meta分析。结果共12篇文献符合。纳入标准,经改良Jadad评分均判定为高质量研究。纳入病例920例。在术后3个月时,EF组仅有前臂旋前角度优于ORIF组(open reduction internal fixation,ORIF)(MD 5.13,95%CI[2.04,8.22],P=0.001),ORIF组的掌屈(MD=-6.15,95%CI[-9.65,-2.65],P=0.0006)、背伸(MD=-11.12,95%CI[-16.59,-5.66],P<0.0001)、尺偏角(MD=-2.70,95%CI[-4.94,-0.46],P=0.02)、旋后(MD=-11.56,95%CI[-16.28,-6.84],P<0.00001)以及握力恢复(MD=-12.82,95%CI[-20.24,-5.41],P=0.0007)均优于EF组。但两组术后6个月及1年ROM和握力恢复的效果相同。ORIF组在术后3个月和1年时均有较好的DASH评分(3个月时DASH评分MD=15.54,95%CI[8.77,22.32],P<0.00001;12个月时DASH评分MD=3.14,95%CI[0.20,6.07],P=0.04)。此外,ORIF组更好地恢复掌倾角(MD=-1.95,95%CI[-3.18,-0.72],P=0.002)及尺骨方差(MD=0.60,95%CI[0.12,1.07],P=0.01),并同时降低了并发症的发生率(MD=1.63,95%CI[1.16,2.28],P=0.005)。两组间在桡倾角、桡骨高度、再手术率,感染以外的并发症发生率差异无统计学意义。结论 ORIF治疗不稳定桡骨远端骨折,术后患者可早期恢复握力并具有较好腕关节活动度,在术后较长时间内有较好的DASH评分,能更好地恢复尺骨方差和掌倾角同�
文摘Background: Colles’ fracture is a type of fracture of the distal third of the radius and its most common cause is falling from patient’s own height and, epidemiologically, it is more common in the elderly. Objectives: The main objective of this study is to analyze the epidemiology of Colles’ fracture retrospectively, in patients admitted to Fernandes Távora Hospital. Materials and Methods: This retrospective study conducted at the Fernandes Távora Hospital used 1030 radiographic images of patients with wrist fractures. Results: (After a careful analysis) It was found that this type of fracture occurred with a greater frequency in age groups of 50 to 69, 60 to 69, and 40 to 49 years old, which corresponds to 59.5% of patients and the most affected sex were females (51.1%). Conclusion: The study concluded that this type of bone injury is more common in people aged 40 to 69 years old, especially in women, because of their geometry and bone composition. It is evident that Colles’ fracture impacts the life of the affected person, therefore, an adequate diagnosis and treatment having utmost importance.
