改良柳木小夹板治疗桡骨下端伸直型骨折的临床观察

Clinical study of advanced small willow splint on distal radius extension fractures

目的比较改良柳木小夹板与传统小夹板治疗桡骨下端伸直型骨折的临床疗效。方法用前瞻性研究方法,将61例桡骨下段伸直型骨折患者分为改良柳木小夹板治疗组、传统小夹板对照组,每组分别为31、30例。进行治疗前、治疗后第1、3、7、30天的疼痛、肿胀评分,比较两组治疗后15 d内的调整次数,评定治疗后第45天疗效。结果治疗组与对照组疼痛、肿胀、调整次数等方面的评分在自身前后对照、治疗后组间对照差异有统计学意义(P<0.05,P<0.01),其中治疗组在治疗前至第3天时段疼痛明显缓解(P<0.05),在第3天至第7天时段肿胀明显减轻(P<0.01),评分降幅分别为(28.71±5.16)、(0.84±0.52)分,15 d内调整次数为(1.58±0.78)次;对照组在第3天至第7天时段疼痛缓解,肿胀评分在第7 d至第30 d时段才明显减轻,评分降幅分别为(13.83±3.13)、(1.40±0.56)分,15 d内调整次数为(3.03±0.81)次。而两组临床疗效总有效率比较差异无统计学意义(P>0.05)。结论改良柳木小夹板外固定治疗桡骨下端骨折,能显著减少骨折早期的肿胀、疼痛和调整次数,是一种安全、有效的新型小夹板外固定器。

Objective To compare the clinical effects of the advanced small willow splint with traditional small splint on the distal radius extension fractures.Methods With the prospective study method,61 patients were divided into two groups： 31 patients in treatment group treated with advanced small willow splint and 30 patients in control group treated with traditional small splint.The scores of pain and swelling were evaluated before treatment and at 1st,3rd,7th and 30th day after treatment,and the number of adjusting small splint within 15 days after treatment was counted,besides clinical effects were evaluated at 45th day after treatment.Results The scores of pain and swelling and the number of adjusting small splint were significantly decreased after treatment in each group andbetween the two groups（P0.05 and P0.01）.In treatment group,pain was obviously relieved within 3 days after treatment（P0.05） and swelling was significantly reduced during the 3rd day and the 7th day（P0.01） with scores declining respectively（28.71±5.16and 0.84±0.52）;the number of adjusting small splint within 15 days after treatment were 1.58 ± 0.78 times（P0.01）.In control group,pain was significantly relieved during the 3rd day and the 7th day after treatment（P0.05） and swelling was significantly reduced during the 7th day and the 30th day（P0.01） with scores declining respectively（13.87±3.08 and 1.39±0.56）;the number of adjusting small splint within 15 days after treatment were 3.03±0.81 times（P0.01）.But the total clinical efficiency between two groups was not significant（P0.05）.Conclusion The advanced small willow splint can significantly reduce pain,swelling and adjustment times in early stages of distal radius extension fractures,which is a new safe and effective method.