手法复位夹板外固定配合温阳健骨方治疗对老年桡骨远端骨折患者桡骨形态与腕关节功能的影响

Effect of manual reduction and splint external fixation combined with Wenyang Jiangu recipe on radius morphology and wrist function in elderly patients with distal radius fracture

目的:探究手法复位夹板外固定配合温阳健骨方对老年桡骨远端骨折患者桡骨形态与腕关节功能的影响。方法:选取2019年11月—2021年8月在我院行手法复位夹板外固定的桡骨远端骨折老年患者90例,采用随机数表法分为观察组和对照组,各45例。对照组采用手法复位夹板外固定法,观察组在对照组的基础上加用温阳健骨方。记录治疗前和治疗1个月后,两组骨代谢水平[血清骨钙素(BGP)、β-胶原特殊序列(β-Cross)];记录治疗前和术后随访3个月时,两组桡骨形态(掌倾角、尺偏角、桡骨高度)参数、腕关节状况[腕关节功能评分(GW量表)、视觉模拟疼痛评分法(VAS)]、中医证候积分。结果:治疗1个月后较治疗前,两组血清BGP水平均有升高,且观察组高于对照组(P均<0.05);两组血清β-Cross水平均有下降(P均<0.05),且观察组低于对照组(P均<0.05)。术后随访3个月时较治疗前,两组桡骨形态(掌倾角、尺偏角、桡骨高度)参数均有上升(P均<0.05),且观察组高于对照组(P均<0.05);术后随访3个月时,两组腕关节状况(GW评分、VASA量表)、各项中医证候积分均有下降(P均<0.05),且观察组低于对照组(P均<0.05)。结论:手法复位夹板外固定配合温阳健骨方能改善腕关节功能及桡骨形态,缓解症状,具有临床价值。

Objective:To explore the effect of manual reduction and splint external fixation combined with Wenyang Jiangu recipe on radius morphology and wrist function in elderly patients with distal radius fracture.Methods:Ninety elderly patients with distal radius fracture who underwent manual reduction and splint external fixation in our hospital from November 2019 to August 2021 were randomly di-vided into observation group(n=45)and control group(n=45).The control group was treated with manual reduction and splint external fixation,and the observation group was treated with Wenyang Jiangu recipe on the basis of the control group.The bone metabolism levels of the two groups[serum osteocalcin(BGP)and collagen special sequence(β-Cross)]were recorded before and 1 month after treatment,and the parameters of radius morphology(metacarpal inclination angle,ulnar deviation angle,radius height),wrist joint status[wrist func-tion score(GW scale),visual analog pain score(VAS)]and TCM syndrome scores were recorded before and 3 months after treatment.Results:One month after treatment,the level of serum BGP in the observation group was higher than that in the control group(all P<0.05),the level of serumβ-Cross decreased in both groups(all P<0.05).and the observation group was lower than that in the control group(all P<0.05).After 3 months of follow-up,the parameters of radius morphology(metacarpal inclination angle,ulnar deviation angle and radius height)increased in both groups(all P<0.05),and those in the observation group were higher than those in the control group(all P<0.05),and the wrist joint condition(GW score,VASA scale)and TCM syndrome scores in the two groups decreased 3 months after operation,and the observation group was lower than that in the control group(P<0.05).Conclusion:Manual reduction and splint external fixation combined with Wenyang Jiangu recipe on radius morphology can improve the function of wrist joint and the shape of radius,re-lieve symptoms,and have clinical value.