[1]陈洋 成永忠△ 黄晓宇 程灏 温建民 刘广伟 蔡静怡 吴钟凯 贺达 邱鹏.旋前-外旋Ⅳ度踝关节骨折逆移位复位手法的尸体标本研究[J].中国中医骨伤科杂志,2020,28(01):8-12.
　CHEN Yang CHENG Yongzhong HUANG Xiaoyu CHENG Hao WEN Jianmin LIU Guangwei CAI Jingyi WU Zhongkai HE Da QIU Peng.Cadaver Study of Reverse Displasement Reduction Maneuver for Grade Ⅳ Pronation-external Rotation Ankle Fracture[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2020,28(01):8-12.
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旋前-外旋Ⅳ度踝关节骨折逆移位复位手法的尸体标本研究()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第28卷
期数:
2020年01期
页码:
8-12
栏目:
实验研究
出版日期:
2020-01-15

文章信息/Info

Title:
Cadaver Study of Reverse Displasement Reduction Maneuver for Grade Ⅳ Pronation-external Rotation Ankle Fracture
文章编号:
1005-0205(2020)01-0008-05
作者:
陈洋1 成永忠2△ 黄晓宇2 程灏2 温建民2 刘广伟2 蔡静怡2 吴钟凯2 贺达2 邱鹏2
1北京中医药大学(北京,100029) 2中国中医科学院望京医院
Author(s):
CHEN Yang1 CHENG Yongzhong2△ HUANG Xiaoyu2 CHENG Hao2 WEN Jianmin2 LIU Guangwei2 CAI Jingyi2 WU Zhongkai2 HE Da2 QIU Peng2
1Beijing University of Chinese Medicine,Beijing 100029,China; 2Wangjing Hospital,China Academy of Chinese Medicine Sciences,Beijing 100102,China.
关键词:
踝;  骨折;  手法复位;  尸体标本
Keywords:
ankle;  fracture;  manual reduction;  cadaver specimen
分类号:
R683.42
文献标志码:
A
摘要:
目的:比较逆移位手法与传统复位手法对旋前-外旋Ⅳ度踝关节骨折的复位效果,验证逆移位手法的科学性。方法:将8对踝关节尸体标本行闭合间断骨钻孔后,根据受伤机制施加暴力,制备旋前-外旋型Ⅳ度踝关节骨折尸体模型。试验采用二阶段配对交叉设计进行。同一尸体左右足进行配对后,随机决定A组先用A方案(逆移位复位手法),再用B方案(传统逆损伤复位手法),则B组先采用B方案,再用A方案,两种方案在研究过程中交叉进行。通过X线观察腓骨的侧方移位及前后移位、内踝分离及侧方移位、后踝向上移位、距骨倾斜、距骨移位、下胫腓间隙,结合Leeds评分进行评定。结果:两种复位手法均能使骨折移位减小,差异有统计学意义(P<0.05)。Leeds分级评定结果示,传统复位手法优良率为87.6%,逆移位手法解剖复位优良率为93%,高于传统复位手法,差异无统计学意义(P>0.05)。逆移位复位手法对各骨折端位移的复位与传统复位手法相比,差异无统计学意义(P>0.05)。结论:两种复位手法治疗治疗旋前-外旋Ⅳ度踝关节骨折复位效果相当。说明不施加旋后内旋也可以达到复位,避免传统复位手法复位过程中出现二次骨折,为在临床中实现踝关节内手法精准复位提供了一种新的思路。
Abstract:
Objective:To compare the reduction effect of inverse displacement reduction treatment and traditional reduction treatment of grade Ⅳ pronation-external rotation ankle fracture to verify the scientific nature of inverse displacement treatment.Methods:Cadaveric models of grade Ⅳ pronation-external rotation ankle fracture were prepared by applying 8 pairs of ankle cadaveric specimens to the closed discontinuous bone borehole according to the injury mechanism.Two-stage paired crossover design was used in the experiment.After matching the left and right feet of the same cadaver,it was randomly determined that plan A(inverse displacement reduction treatment)was used first in group A,and then plan B(traditional reduction treatment)was used,while plan B was used first in group B,and then plan A was used.The lateral displacement and anterior and posterior displacement of fibula,medial malleolus separation and lateral displacement,posterior malleolus upward displacement,talus inclination,talus displacement,and lower tibiofibular space were observed by X-ray,and the Leeds score was used to evaluate.Results:The displacement of fracture can be reduced by these two reduction treatments,and the difference was statistically significant.Leeds grading evaluation results showed that the excellent and good rate of traditional reduction treatment was 87.6%,and the excellent and good rate of the inverse displacement treatment was 93%,which was higher than the traditional reduction treatment,but the difference was not statistically significant(P>0.05).There was no statistically significant difference between the inverse displacement reduction treatment and the traditional reduction treatment in the reduction of the displacement of each fracture end(P>0.05).Conclusion:Two kinds of reduction treatments are equivalent to the treatment of grade Ⅳ pronation-external rotation ankle fracture reduction.It is indicated that reduction can be achieved without applying the supination internal rotation,and avoided the occurrence of secondary fracture during the traditional reduction treatment,which provides a new method for the accurate reduction of the ankle joint in the clinical practice.

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备注/Memo

备注/Memo:
基金项目:北京市自然科学基金资助项目(7172243)(收稿日期:2019-05-13)△通信作者 E-mail:bless518@139.com
更新日期/Last Update: 2020-01-15