[1]张新国 王彬 曾艳阳 杨俊兴 赵亮△.“过伸推按抖折手法”联合改良夹板治疗桡骨远端伸直型骨折29例[J].中国中医骨伤科杂志,2022,30(07):49-52.
 ZHANG Xinguo WANG Bin ZENG Yanyang YANG Junxing ZHAO Liang.29 Cases Clinical Study on Extension Fracture of Distal Radius with “Hyperextension Push and Shake” Combined with Modified Splint[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2022,30(07):49-52.
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“过伸推按抖折手法”联合改良夹板治疗桡骨远端伸直型骨折29例()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第30卷
期数:
2022年07期
页码:
49-52
栏目:
临床报道
出版日期:
2022-07-15

文章信息/Info

Title:
29 Cases Clinical Study on Extension Fracture of Distal Radius with “Hyperextension Push and Shake” Combined with Modified Splint
文章编号:
1005-0205(2022)07-0049-04
作者:
张新国1 王彬1 曾艳阳1 杨俊兴1 赵亮1△
1广州中医药大学深圳医院(福田)(广东 深圳,518034)
Author(s):
ZHANG Xinguo1 WANG Bin1 ZENG Yanyang1 YANG Junxing1 ZHAO Liang1△
1Shenzhen Hospital,Guangzhou University of Traditional Chinese Medicine,Shenzhen 518034,Guangdong China.
关键词:
正骨疗法 夹板固定 桡骨远端骨折 骨折再移位 局部挤压伤
Keywords:
bone setting splint fixation colles fracture reduction displacement local crush injury
分类号:
R683.41
文献标志码:
B
摘要:
目的:观察改良正骨疗法“过伸推按抖折手法”联合改良夹板固定治疗中老年桡骨远端伸直型骨折的临床疗效及对复位后骨折再移位、皮肤挤压伤发生率的影响。方法:选取2020年1月至2021年3月收治的29例中老年桡骨远端伸直型(Colles)骨折患者,均为摔倒伤后即刻就诊的新鲜闭合性骨折。运用改良后的中医正骨“过伸推按抖折法”联合改良夹板进行治疗,治疗后8周观察复位后骨折再移位、皮肤挤压伤发生率,评估治疗前后桡骨远端的高度、掌倾角、尺偏角、VAS疼痛评分改善情况,针对腕关节功能恢复采用Cooney评分进行疗效分析评估。结果:29例患者全部获得了8周的随访,均采用本方法一次性复位治疗,复位后骨折端再移位1例(发生率为3.45%),均未出现皮肤挤压性损伤情况。治疗后8周桡骨远端的高度、掌倾角、尺偏角、VAS疼痛评分均较治疗前改善明显,差异有统计学意义(P<0.05)。所有患者均未出现畸形愈合、神经血管损伤等并发症。综合腕关节功能Cooney评分疗效评价:优18例,良11例,优良率为100%。结论:运用改良的正骨疗法“过伸推按抖折手法”联合改良夹板固定治疗中老年桡骨远端伸直型闭合性骨折,明显降低了复位后骨折再移位发生率、皮肤挤压伤率,其具有操作手法安全、复位精准、固定稳固、腕关节功能恢复好等优点,值得临床推广应用。
Abstract:
Objective:To observe the clinical efficacy of modified bone setting technique of “hyperextension pushing and shaking” combined with modified splint fixation on the treatment of extended fracture of the distal radius and its efficacy on the incidence of bone displacement at the fracture end and skin crush injury after reduction.Methods:A total of 29 middle-aged and elderly patients with Colles fractures were selected from January 2020 to March 2021,all of which were fresh closed fractures immediately after fall injury.They were treated with modified bone setting technique of “hyperextension pushing and shaking” combined with modified splint fixation for 8 weeks.The incidence of fracture re displacement and skin crush injury after reduction were observed 8 weeks after treatment.The improvement of distal radius height,palmar inclination,ulnar deviation and VAS pain score before and after treatment were evaluated.Cooney score was used to analyze and evaluate the curative efficacy for the recovery of wrist function.Results:All the 29 patients were followed up for 8 weeks,and all of them were treated with one-time reduction by this method.The fracture end was displaced in 1 case,with an incidence of 3.45%,and no skin compression injury occurred after reduction.The height of distal radius,palmar Angle,ulnar deviation Angle and VAS pain score at 8 weeks after treatment were significantly improved compared with those before treatment with statistically significant differences(P<0.05).None of the patients had malunion,neurovascular injury and other complications.In the treatment group,18 cases were excellent and 11 cases were good,with an excellent and good rate of 100%.Conclusion:The modified bone setting technique of “hyperextension pushing and shaking” combined with modified splint fixation can significantly reduce the incidence of fracture end shift again after reset,skin squeeze the damage rate.It has the advantages of reliable safety,accurate reduction,stable fixation and good recovery of wrist function,which is worthy of clinical promotion.

参考文献/References:

[1] 潘廷明,董忠,杨连梓,等.手法复位石膏外固定联合中药熏洗和切开复位钢板内固定治疗骨质疏松性桡骨远端骨折疗效比较[J].中国中西医结合杂志,2019,39(1):63-66.
[2] 李斌.对比分析小夹板外固定与石膏外固定治疗桡骨远端骨折的临床价值[J].中国伤残医学,2020,28(6):41-42.
[3] 吴同岭,侯伟东,唐向阳,等.三柱理论指导外固定架与锁定钢板内固定治疗AO-C型桡骨远端骨折的比较[J].中国骨与关节损伤杂志,2018,33(7):697-700.
[4] TSAI C H,TSAI C H,HSU C J,et al.External fixator for maintaining reduction before volar plating:a simple treatment method for association of osteosynthesis type C3 distal radius fracture[J].Tech Hand Up Extrem Surg,2016,20(1):14-20.
[5] MISHRA R K,SHARMA B P,KUMAR A,et al.A comparative study of variable angle volar plate and bridging external fixator with K-wire augmentation in comminuted distal radius fractures[J].Chinese Journal of Traumatology,2021,5(24):301-305.
[6] 刘志昂,张陆,刘军,等.手法复位小夹板固定和切开复位内固定治疗骨质疏松型桡骨远端骨折的优劣势差异[J].实用中西医结合临床,2018,18(10):131-132.
[7] 欧良,卢敏,张永辉,等.手法复位小夹板固定治疗老年桡骨远端骨折临床疗效Meta分析[J].中国中西医结合杂志,2019,39(1):57-62.
[8] 韦欢,黄福才,杨群有,等.桡骨远端骨折高分子石膏夹板与小夹板固定疗效对比[J].实用中西医结合临床,2018,18(6):130-131.
[9] 魏立友,李忠民,张文芳,等.小夹板和锁定钢板治疗老年人桡骨远端关节内骨折的比较[J].中国矫形外科杂志,2017,25(24):2238-2243.
[10] 莫军杰,孙奇,周君鹏,等.老年伸直型桡骨远端骨折手法复位夹板外固定治疗后骨折移位的危险因素分析[J].中医正骨,2021,33(8):572-575.
[11] 赵俊峰,程晋科,张天健,等.不同曲度夹板固定治疗伸直型桡骨远端骨折的临床研究[J].中医药临床杂志,2021,33(11):2219-2223.
[12] 胥少汀,葛宝丰,徐印坎.实用骨科学[M].4版.北京:人民军医出版社,2015:576-578.
[13] 张勇,牟健,刘牧,等.接骨续筋膏外敷结合小夹板固定治疗伸直型桡骨远端骨折患者79例[J].中国中医骨伤科杂志,2021,29(5):43-46.
[14] 雷雨擎,赵长伟,赵文海,等.“牵捺抖”手法配合消肿散治疗老年桡骨远端骨折的疗效分析[J].中国中医骨伤科杂志,2022,30(2):22-25.
[15] 刘凯,叶永亮,胡建炜,等.手法复位桡骨远端骨折后再移位92例原因分析[J].中国中医骨伤科杂志,2020,28(10):61-64.
[16] 李育敏,李世梁,孙海东,等.桡骨远端骨折手法复位小夹板固定后轴向再短缩移位相关因素分析[J].临床医药实践,2020,29(2):102-106.
[17] WALENKAMP M M,AYDIN S,MULDERSMA,et al.Predictors of unstable distal radius fractures:a systematic review and meta-analysis[J].J Hand Surg:Eur Vol,2016,41(5):501-515.
[18] CAMUR S,SERKAN B,OMER P,et al.Clinical outcomes comparison of distal radius fractures between two conservative treatment methods:Below-arm cast versus reverse sugar tong splint[J].Journal of Orthopaedic Science,2021,5(26):804-811.
[19] 奚彬,杨莹,李冬成,等.桡骨远端双柱die-punch骨折影像学类型:骨折分型及力学机制[J].中国组织工程研究,2018,22(27):4405-4409.
[20] 胡文昕,胡文虎,刘秀丽,等.胡黎生教授治疗肱骨髁间闭合性骨折经验[J].吉林中医药,2021,41(12):1597-1599.
[21] 段星星,马奇翰,高锋,等.纸夹板联合木夹板固定治疗闭合性桡骨远端骨折的临床研究[J].中医正骨,2021,33(5):344-347.

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更新日期/Last Update: 1900-01-01