[1]俞鹏飞 裴帅 沈晓峰 陆斌杰 徐甄理张志刚 张龙 李宇卫 龚正丰 李红卫△.龚氏四步复位法术前复位对旋后外旋型Ⅳ度踝关节骨折围手术期疗效的影响[J].中国中医骨伤科杂志,2021,29(11):71-75.
　YU Pengfei PEI Shuai SHEN Xiaofeng LU Binjie XU Zhenli ZHANG ZhigangZHANG Long LI Yuwei GONG Zhengfeng LI Hongwei.Efficacy of Gong’s Four-Step Manipulative Reduction Technique on Perioperative Outcome of Supination and External Rotation Type Ⅳ Degree Ankle Fracture[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(11):71-75.
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龚氏四步复位法术前复位对旋后外旋型Ⅳ度踝关节骨折围手术期疗效的影响()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年11期
页码:
71-75
栏目:
临床报道
出版日期:
2021-11-15

文章信息/Info

Title:
Efficacy of Gong’s Four-Step Manipulative Reduction Technique on Perioperative Outcome of Supination and External Rotation Type Ⅳ Degree Ankle Fracture
文章编号:
1005-0205(2021)11-0071-05
作者:
俞鹏飞1 裴帅1 沈晓峰1 陆斌杰1 徐甄理1张志刚1 张龙2 李宇卫1 龚正丰1 李红卫1△
Author(s):
YU Pengfei1 PEI Shuai1 SHEN Xiaofeng1 LU Binjie1 XU Zhenli1 ZHANG Zhigang1ZHANG Long2 LI Yuwei1 GONG Zhengfeng1 LI Hongwei1△
1Suzhou Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, Suzhou 215009, Jiangsu China; 2Nanjing University of Traditional Chinese Medicine,Nanjing 210046,China.
关键词:
踝关节骨折;  劳格-汉森分型;  旋后外旋Ⅳ度;  正骨手法;  吴门医派
Keywords:
ankle fracture;  Lauge-Hansen classification;  supination and external rotation type Ⅳ;  fracture reduction technique;  Wumen medicine
分类号:
R683.42
文献标志码:
B
摘要:
目的:观察龚氏四步复位法术前复位对旋后外旋型Ⅳ度踝关节骨折围手术期疗效的影响。方法:2018年1月至2020年1月期间完成治疗的旋后外旋型Ⅳ度踝关节骨折患者30例,予以龚氏四步复位法复位、石膏固定、手术治疗,分析患者围手术期患肢疼痛VAS评分、术后踝关节功能AOFAS评分、张力性水泡、切口皮缘坏死渗液等并发症情况。结果:本组患者的术前等待时间为(3.03±1.23)d,手术时间为(78.67±26.93)min。VAS评分入院时为(6.97±1.13)分,复位后为(4.67±1.39)分; 术前1 d为(3.41±1.13)分,术后3 d为(3.17±1.02)分,术后14 d为(1.67±0.61)分。术后3个月时AOFAS评分为(57.00±5.28)分,术后6个月评分为(77.37±5.92分),术后12个月为(85.53±4.85)分。切口并发症方面,仅发生张力性水泡2例(发生率6.7%),无切口皮缘坏死及渗液病例,切口均Ⅰ/甲愈合。结论:术前及时采用龚氏四步复位法手法复位,能较快减轻旋后外旋型Ⅳ度踝关节骨折患者术前疼痛,使患者具备较好的软组织条件及骨折对位条件,缩短术前等待时间,便于手术操作,术后踝关节功能持续恢复,并发症发生率低。
Abstract:
Objective:To observe the efficacy of Gong’s four-step manipulative reduction technique preoperatively on perioperative outcome of supination and external rotation type Ⅳ degree ankle fracture.Methods:30 patients with Ⅳ degree of supination and external rotation ankle fracture from January 2018 to January 2020 were treated with Gong’s four-step reduction method, plaster fixation and surgery.Perioperative VAS score of limb pain, preoperative waiting time, operative time, postoperative AOFAS score of ankle joint function, and complications such as tension blisters, incision skin edge necrosis and exudation were analyzed.Results:In this group, the preoperative waiting time was(3.03±1.23)d, and the operation time was(78.67±26.93)min.All patients were followed up for more than 1 year.VAS scores were 6.97±1.13 on admission, 4.67±1.39 after reduction, 3.41±1.13 on 1 d before surgery, 3.17±1.02 on 3 d after removal of analgesic pump and 1.67±0.61 on 14 d.The AOFAS scores were 57.00±5.28 at 3 months, 77.37±5.92 at 6 months and 85.53±4.85 at 12 months.In terms of complications, tension blisters occurred in 2 cases before operation(6.7%).There were no cases of skin edge necrosis and exudation.All the incisions were I/A healing.Conclusion:The preoperative using of Gong’s four-step manipulative reduction technique can relieve the preoperative pain of the patients with Ⅳ degree ankle fracture of supination and external rotation type.Gong’s four-step reduction method combined with surgical treatment can relieve postoperative pain in patients with Ⅳ degree of lateral rotation type ankle fracture, and the postoperative recovery is fast and the complication rate is low.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目:江苏省青年医学重点人才项目(QNRC2016253)
苏州市姑苏卫生人才计划(青年拔尖人才)
[2020(126)]
1南京中医药大学附属苏州市中医医院(江苏 苏州,215009)
2南京中医药大学
△通信作者 E-mail:hongwei_li151@126.com
更新日期/Last Update: 1900-01-01