高频超声引导Colles骨折手法复位的价值

High-frequency ultrasound guided reduction of Colles fracture

目的:探讨应用高频超声引导Colles骨折手法复位治疗的价值。方法:本组Colles骨折患者46例,年龄19～76岁,平均47.2岁,男32例,女32例,行高频超声引导下的闭合复位外固定治疗;对照组Colles骨折徒手闭合复位外固定46例,年龄21～69岁,平均42.8岁,男29例,女17例。所有患者复位外固定后即刻X线摄片并与健侧比较,测量患侧桡骨远端背侧倾斜角、掌倾角、尺偏角、桡骨的短缩值评价首次复位成功率和复位质量。结果:(1)按解剖学复位评估标准,首次复位成功率研究组比对照组高(P<0.05);(2)成功复位后,掌倾角减少研究组比对照组小(P<0.05);尺偏角减少研究组比对照组小(P<0.05);桡骨短缩研究组与对照组相似(P>0.05)。结论:应用高频超声引导Colles骨折手法闭合复位,能提高首次复位成功率和复位质量。

Objectives：To assess whether high-frequency US guidance would aid in determining the adequacy of Colles fracture reduction,and to compare the adequacy of successful reduction with and without US.Methods：A prospective study was conducted on patients who underwent US-guided reduction of Colles fracture,compared with a historical cohort without US guidance.Both with and without US guidance groups contained 46 patients respectively.After performing US-guided reduction,but before post-reduction radiographs,all patients treaded with a plaster fixation immediately.Successful radiographic reduction was determined on the basis of radiographic findings with the measurements of the dorsal tilt angle,the lateral articular angle,the ulnar tilt angle and the radial length.Results：（1） Comparing the rates of successful reduction in the first time with and without US,the study group was higher than the control group.The difference was statistically significancant（P0.05） .（2） Comparing the adequacy of successful reduction with and without US,the decrease of lateral articular angle contrast to normal side in the study group was less than that in the control group,the difference was statistically significancant（P0.05） ,the decrease of ulnar tilt angle contrast to normal side in the study group was less than that in the control group,the difference was statistically significancant（P0.05） .The radial shortenings were similar in both groups,the difference was of no statistical significance（P0.05） .Conclusion：The successful rate of Colles fracture closed reduction using US guidance was higher than that without US at the first time.High sensitivity in reduction of Colles fractures was performed using US guidance.