塑性弹力夹板与普通小夹板治疗桡骨远端伸直型骨折的比较

Comparison between plastic splint and traditional splint for the treatment of Colles fracture

目的:评价塑性弹力夹板治疗桡骨远端伸直型骨折的临床疗效。方法:选择2002-09/2005-08在河南中医学院第二附属医院骨科、河南中医学院第一附属医院骨科、登封市骨科医院就诊的210例桡骨远端伸直型骨折患者,随机分为对照组和治疗组,每组105例。对照组骨折整复后应用普通小夹板掌屈位固定,治疗组整复后应用塑性弹力夹板中立位固定。在就诊当日、1周、4～6周3个观察周期以病情变化总分评价病情轻重,观察周期结束后3个月按照Gartland和Werley评分系统对腕关节功能进行评价。结果:治疗1周末治疗组骨折再移位、肢体肿胀、腕关节外形评分高于对照组(P<0.05)。去除固定器后治疗组肢体肿胀和腕关节外形评分高于对照组(P<0.05)。治疗组腕关节功能优于对照组(P<0.01)。结论:塑性弹力夹板治疗桡骨远端伸直型骨折早期对骨折再移位的预防明显好于普通小夹板,并且可以有效地缓解患部肿胀、改善外形。

OBJECTIVE： To evaluate the clinical effect of the plastic splint on the treatment of Colles fracture. METHODS： A total of 210 patients with Colles fracture were collected from the Department of Orthopedics, the Second Hospital Affiliated to Henan College of Traditional Chinese Medicine, the Department of Orthopedics, the First Hospital Affiliated to Henan College of Traditional Chinese Medicine, and Dengfeng Orthopedics Hospital between September 2002 and August 2005. All patients were randomly divided into control group and treatment group, with 105 cases in each group. Palmar flexion was performed in the control group using traditional splint, while median flexion was performed in the treatment group using the plastic splint. The degree of the diseases was judged by total scores at the first day, one week later, and four or six weeks later. According to Gartland and Werley scoring system, the function of wrist was evaluated after 3 months. RESULTS： At the first week, the integration score including reposition, swelling and contour of the wrists in the treatment group was significantly higher than the control group （P 〈 0.05）. After removing the external fixation device, the scores in the treatment group were also significantly higher than control group （P 〈 0.05）. The function of wrist in the treatment group was better than control group （P 〈 0.01）. CONCLUSION： The plastic splint is superior to traditional splint to prevent displacement of Colles fracture in an early stage; especially, it is beneficial for effectively relieve swelling and improve the contour of the wrists.