3D打印外固定支具联合伤科紫草油促进桡骨远端骨折后腕关节功能的恢复

3D printed orthopedic cast combined with Zicao oil promotes the recovery of wrist joint function after distal radius fracture

背景:3D打印外固定支具能够针对骨折患者制定个体化的外固定方案并且佩戴方便,而伤科紫草油具有消肿化瘀辅助骨折康复治疗的功效,两者联合有利于骨折保守治疗患者的康复。目的:评估3D打印外固定支具联合伤科紫草油治疗桡骨远端骨折的临床效果,为寻求一种促进桡骨远端骨折后腕关节功能恢复的中西医结合治疗方案提供依据。方法:纳入桡骨远端骨折患者64例并随机分为2组,试验组骨折手法整复后采用3D打印外固定支具联合伤科紫草油治疗,对照组骨折手法整复后采用伤科紫草油联合常规夹板外固定治疗。比较2组患者拆除外固定后2周的Jakim桡骨远端骨折疗效评分及其优良率,从疼痛程度、肿胀程度、腕关节活动范围、抓握能力、畸形程度方面进行评价。结果与结论:①试验组疗效优良率为94%,对照组为78%,2组间比较差异有显著性意义(P<0.01);②2组治疗后2,4,8,14 d腕关节活动范围评分及目测类比评分均显著优于治疗前(P<0.01);治疗后不同时点,2组间比较,试验组腕关节活动范围评分及目测类比评分均显著优于对照组(P<0.05);③治疗后2,4,8,14 d的肿胀程度,试验组均优于对照组(P<0.05);④说明3D打印外固定支具联合伤科紫草油治疗桡骨远端骨折效果确切,可有效改善患者腕关节功能,减轻患者痛苦,提升康复质量。

BACKGROUND:3D printing external fixation fixture can make individualized external fixation scheme for fracture patients and is easy to wear.Zicao oil(a Chinese traditional medicine oil)for trauma treatment has the effect of reducing swelling and removing blood stasis to assist the rehabilitation treatment of fracture.The combination of the two could benefit the rehabilitation of patients with fracture conservative treatment.OBJECTIVE:To investigate the clinical application value of the 3D printed orthopedic cast combined with Zicao oil in the treatment of distal radial fracture,hoping to provide a basis for the further study of a combined Chinese and western medicine treatment scheme for the recovery of wrist function after distal radius fractures.METHODS:Sixty-four patients with distal radial fracture were selected and randomly divided into two groups.Patients in the trial group received 3D-printed cast combined with Zicao oil treatment after manual reduction.Patients in the control group received traditional splint cast combined with Zicao oil after manual reduction.The Jakim scoring for distal radial fracture treatment,as well as pain degree,swelling degree,wrist range of motion,grasping ability and deformity degree were evaluated and compared 2 weeks after removal of external fixation in both groups.RESULTS AND CONCLUSION:(1)The excellent and good rate was 94%in the trial group and 78%in the control group.There was significant difference between the two groups(P<0.01).(2)At 2,4,8 and 14 days after treatment,the scores of wrist range of motion and visual analogue scale were significantly better than those before treatment(P<0.01).At different time points after treatment,the scores of wrist range of motion and visual analogue scale in the trial group were significantly better than those in the control group(P<0.05).(3)The swelling degree of the trial group was better than that of the control group 2,4,8 and 14 days after treatment(P<0.05).(4)The results show that 3D printed cast combined with Zicao oil is effective in the treatment of distal radius fracture,can effectively improve the function of wrist joint,reduce the pain of patients and improve the quality of rehabilitation.