低温板材外固定治疗桡骨远端伸直型骨折96例:与夹板外固定及石膏夹板超腕外固定的比较

Cold plate external fixation for distal radius extension fractures in 96 cases:Comparison with plaster splint external fixation and practitioner external fixation

背景:目前常见的桡骨远端骨折外固定方式包括石膏外固定、中医夹板,低温板材支具固定是新发展起来的外固定方法,与其他固定方式相比有无优势尚不清楚。目的:观察低温板材外固定法对桡骨远端伸直型骨折功能恢复的治疗效果。方法:四川大学华西康复科假肢矫形中心2007-12/2010-01收治的96例桡骨远端伸直型骨折患者,随机分为低温板材超腕外固定组、中医桡骨远端骨折夹板外固定组、石膏夹板超腕外固定组,每组32例。各组均给予手法复位操作治疗以及适当的功能训练,并根据患者年龄、身体情况及损伤程度予以药物治疗。结果与结论:与低温板材超腕外固定组比较,中医桡骨远端骨折夹板外固定组、石膏夹板超腕外固定组的治愈率明显降低(P<0.05),并发症率、功能受限率均明显升高(P<0.05)。提示手法整复低温板热塑板材外固定治疗桡骨远端伸直型骨折安全、有效,其效果优于传统的石膏固定和中医夹板固定,且并发症少,值得推广应用。

BACKGROUND： Common external fixation methods for distal radius fracture include plaster external fixation and Chinese medical practitioner, low-temperature thermoplastic brace is a new developed method for external fixation, it remains unclear whether it is superior to other fixation methods. OBJECTIVE： To observe the therapeutic effectiveness on the functional recovery of extension fracture in the distal radius by using low-temperature thermoplastic braces. METHODS： A total of 96 patients with extension fracture in the distal radius were recruited from West China Prosthetic Orthopedic Centre of Sichuan University from December 2007 to January 2010. They were randomly divided into three groups, low-temperature thermoplastic braces, Chinese medical practitioner and plaster splints, with 32 cases in each group. All groups underwent manipulative reduction and suitable functional exercise, as well as medication according to the age, healthy state and injury state of the patients. RESULTS AND CONCLUSION： Compared with low-temperature thermoplastic braces group, the healing rate was significantly reduced in Chinese medical practitioner and plaster splints groups （P 0.05）, the complications and restricted range of motion were significantly increased （P 0.05）. The external fixation with manipulative reduction and low-temperature thermoplastic brace outperformed the conventional approaches using plates and plaster splints. It is safe, effective, functional, and produces less complications which is recommended for extended uses.