[1]陈建昌△,黄春银.手法整复配合超声检查治疗成人移位伸直型桡骨远端骨折[J].中国中医骨伤科杂志,2026,34(04):60-65.[doi:10.20085/j.cnki.issn1005-0205.260410]
　CHEN Jianchang,HUANG Chunyin.The Effect of Ultrasound-Guided Closed Reduction for Dorsal Displaced Distal Radial Fractures[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2026,34(04):60-65.[doi:10.20085/j.cnki.issn1005-0205.260410]
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手法整复配合超声检查治疗成人移位伸直型桡骨远端骨折()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第34卷
期数:
2026年04期
页码:
60-65
栏目:
临床研究
出版日期:
2026-04-10

文章信息/Info

Title:
The Effect of Ultrasound-Guided Closed Reduction for Dorsal Displaced Distal Radial Fractures
文章编号:
1005-0205(2026)04-0060-06
作者:
陈建昌1△; 黄春银1
1福建中医药大学附属第二人民医院(福州,350003)
Author(s):
CHEN Jianchang1△; HUANG Chunyin1
1The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou 350003,China.
关键词:
超声引导下闭合复位;  桡骨远端骨折;  手法整复
Keywords:
ultrasound-guided closed reduction;  distal radius fractures;  manual reduction
分类号:
R683.41
DOI:
10.20085/j.cnki.issn1005-0205.260410
文献标志码:
A
摘要:
目的:探讨手法整复配合超声检查是否有助于提高桡骨远端骨折整复的成功率。方法:回顾性分析2022年10月至2024年6月就诊的桡骨远端骨折的患者资料。超声辅助手法整复组(A组)复位过程中采用超声技术辅助手法整复,单纯手法整复组(B组)为传统手法整复固定后拍片复查。复位前后均行X线检查,对比两组的复位成功率,复位前后的掌倾角、尺偏角、桡骨长度、尺骨变异,以及腕关节Quick DASH评分。结果:总共收集120例患者病历资料,超声辅助手法整复组和单纯手法整复组各60例。两组患者在年龄、性别、体重指数、骨折分型、受伤至就诊时间、是否合并尺骨茎突骨折方面差异均无统计学意义(P>0.05)。A组首次复位成功率为91%,B组首次复位成功率为71%,两组首次复位成功率差异有统计学意义(P=0.01)。复位后即刻复查X线片,测量两组掌倾角、尺偏角、桡骨高度、尺骨变异参数,其中超声辅助手法整复组掌倾角、尺偏角有明显改善(9°(-8°,20°)vs 5°(-8°,10°),W=2 740,P<0.01; 15°(10°,20°)vs 12°(0°,20°),W=1 316,P=0.01)。骨折后5个月随访进行Quick DASH评分,两组之间评分差异无统计学意义(0(0,6.8)分 vs 0(0,9.1)分,W=1 768,P=0.86)。结论:手法整复配合超声检查能明显提高桡骨远端骨折整复的成功率。
Abstract:
Objective:To evaluate whether ultrasound-guided manipulations improve the success rates of closed reduction for distal radius fractures.Methods:Patients who underwent closed reduction for dorsally displaced distal radius fractures between October 2022 and June 2024 were retrospectively reviewed.Theultrasound-guided group was performed under ultrasound guidance.The non-ultrasound-guided group consisted of patients who underwent closed reduction without imaging assistance during the procedure.X-ray images of the distal radius were obtained for all patients before and after manipulative reduction.X-ray parameters,Quick DASH scores,and success rates were compared between the ultrasound-guided group and the non-ultrasound-guided group.Results:We reviewed 120 patients:the ultrasound-guided group(group A)consisted of 60 patients,and the non-ultrasound-guided group(group B)also consisted of 60 patients.There were no significant differences between the groups in regard to age,gender,body mass index(BMI),fracture classification,time to presentation,ulnar styloid fracture,and X-ray parameters before reduction(P>0.05).The success reduction rates of the group A and the group B were 91% and 71%,respectively.There was a significant difference in the success rate(P=0.01).Several radiographic measurements were collected immediately after reduction,including dorsal/volar tilt of the radius,radial height,radial inclination,and ulnar variance.Dorsal/volar tilt of the radius and radial inclination were improved in the ultrasound-guided group(9°(-8°,20°)vs 5°(-8°,10°),W=2 740,P<0.01; 15°(10°,20°)vs 12°(0°,20°),W=1 316,P=0.01).However,the Quick DASH scores revealed no significant difference between the two groups after 5 months(0(0,6.8)points vs 0(0,9.1)points,W=1 768,P=0.86).Conclusion:Ultrasound-guided closed reduction can aid in the manipul- ative reduction of distal radius fractures.

参考文献/References:

[1] RUNDGREN J,BOJAN A,MELLSTRAND NAVARRO C,et al.Epidemiology,classification,treatment and mortality of distal radius fractures in adults:an observational study of 23,394 fractures from the national Swedish fracture register[J].BMC Musculoskeletal Disorders,2020,21(1):88.
[2] GULLBORG E J,KIM J H,WARD C M,et al.Optimizing treatment strategies for distal radius fractures in osteoporosis:a comparative review[J].Medicina,2024,60(11):1848.
[3] AHMED O,BALAKRISHNAN P,PERUMAL R,et al.A prospective randomized control trial comparing outcomes of casting,pinning,and plating for distal end of radius fractures(AO type A2,A3,C1,or C2)in the elderly population[J].European Journal of Orthopaedic Surgery & Traumatology,2024,34(5):2473-2482.
[4] 中华医学会骨科学分会创伤骨科学组,中华医学会骨科学分会外固定与肢体重建学组.中国成人桡骨远端骨折诊疗指南(2023)[J].中华创伤骨科杂志,2023,25(1):6-13.
[5] 李传玲,吕辉照,梁志白,等.全程超声引导下闭合复位治疗妊娠期桡骨远端骨折17例[J].中国中医骨伤科杂志,2023,31(2):66-69.
[6] ANG S H,LEE S W,LAM K Y.Ultrasound-guided reduction of distal radius fractures[J].The American Journal of Emergency Medicine,2010,28(9):1002-1008.
[7] MALIK H,APPELBOAM A,NUNNS M.Ultrasound-directed reduction of distal radius fractures in adults:a systematic review[J].Emergency Medicine Journal,2021,38(7):537-542.
[8] GENTLEMAN R,IHAKA R.R:a language and environment for statistical computing[J].Computing,2011,1:12-21.
[9] 吴小宝,郑晓蓉,萧庆瑞,等.南少林牵引旋摇手法治疗桡骨远端月骨关节面压缩骨折134例[J].中国中医骨伤科杂志,2023,31(4):60-63.
[10] SNELLING P J,JONES P,BADE D,et al.Ultrasound secondary signs for the diagnosis of pediatric distal forearm fractures:a diagnostic study[J].Ultrasound in Medicine & Biology,2024,50(6):898-907.
[11] VAN DER LINDEN W,ERICSON R.Colles' fracture.How should its displacement be measured and how should it be immobilized?[J].The Journal of Bone & Joint Surgery,1981,63(8):1285-1288.
[12] 国家骨科医学中心(北京积水潭医院),中华医学会骨科学分会创新与转化学组,中国康复医学会骨与关节康复专业委员会创伤学组,等.成人桡骨远端骨折诊断与治疗循证指南(2024)[J].中华创伤骨科杂志,2024,26(9):737-753.
[13] CHERN T C,JOU I M,LAI K A,et al.Sonography for monitoring closed reduction of displaced extra-articular distal radial fractures[J].The Journal of Bone and Joint Surgery:American Volume,2002,84(2):194-203.
[14] KODAMA N,TAKEMURA Y,UEBA H,et al.Ultrasound-assisted closed reduction of distal radius fractures[J].The Journal of Hand Surgery,2014,39(7):1287-1294.
[15] LAFONTAINE M,HARDY D,DELINCE P.Stability assessment of distal radius fractures[J].Injury,1989,20(4):208-210.
[16] MEINBERG E G,AGEL J,ROBERTS C S,et al.Fracture and dislocation classification compendium-2018[J].Journal of Orthopaedic Trauma,2018,32(S1):S1-S10.
[17] CANGUSSU B L,BALDANZA H C,CARMO R L,et al.Radiographic evaluation of conservative treatment of distal radius fractures[J].Acta Ortopedica Brasileira,2024,32(2):e275070.
[18] MACKENNEY P J,MCQUEEN M M,ELTON R.Prediction of instability in distal radial fractures[J].The Journal of Bone and Joint Surgery:American Volume,2006,88(9):1944-1951.
[19] HOFFER A J,ST GEORGE S A,BANASZEK D K,et al.If at first you don't succeed,should you try again?The efficacy of repeated closed reductions of distal radius fractures[J].Archives of Orthopaedic and Trauma Surgery,2023,143(8):5095-5103.
[20] SYNN A J,MAKHNI E C,MAKHNI M C,et al.Distal radius fractures in older patients:is anatomic reduction necessary?[J].Clinical Orthopaedics and Related Research,2009,467(6):1612-1620.
[21] BROGREN E,HOFER M,PETRANEK M,et al.Relationship between distal radius fracture malunion and arm-related disability:a prospective population-based cohort study with 1-year follow-up[J].BMC Musculoskeletal Disorders,2011,12(1):9.
(收稿日期:2025-08-27)

备注/Memo

备注/Memo:
△通信作者 E-mail:ribenyuchen@163.com
更新日期/Last Update: 2026-04-15