电话回访在门诊保守治疗桡骨远端骨折患者中的应用效果

Analysis of the effect of conservative treatment of distal radius fracture by telephone follow - up with clinic patients

目的 通过对门诊手法复位小夹板或石膏固定治疗桡骨远端骨折患者进行电话回访监督,探讨电话回访对门诊保守治疗桡骨远端骨折患者的效果.方法 回顾分析2007年1月至2008年12月（非电话回访组,对照组64例）和2009年1月至2010年12月（电话回访组,观察组71例）在我院门诊采用闭合复位小夹板或石膏固定治疗桡骨远端骨折并获得随访资料患者的临床资料,制定电话随访表,第1周内每天随访,以后根据每个患者的具体情况定期随访,监督患者观察外固定的松紧度及指导功能康复训练.比较两组患者骨折愈合情况及Gartland-Werley腕关节评分.结果 两组患者术后均获随访,平均随访时间为19个月.对照组9例,观察组2例患者出现骨折复位丢失,两组比较,差异无统计学意义（x^2 =5.688,P=0.017）；X线片示两组桡骨远端骨折均愈合,对照组愈合时间为（10.4±1.8）周,观察组为（10.9±2.3）周,两组比较,差异无统计学意义（t=1.396,P=0.165）；桡骨远端骨折愈合时观察组掌倾角、尺偏角及桡骨长度分别为（8.4±1.5）°,（20.1±2.0）°,（8.9±1.6）mm,均大于对照组的（7.5±1.7）°,（19.1±2.4）°,（8.2±1.4）mm,差异均有统计学意义（t分别为3.268,2.216,2.692;P＜0.05）；末次随访时观察组Gartland-Werley腕关节评分优于对照组,差异有统计学意义（Z=-1.994,P=0.046）.结论 电话回访可监督桡骨远端骨折患者观察外固定的松紧度以防止复位丢失,指导患者功能康复训练,效果满意.

Objective To investigate the effect of the telephone visit for conservative treatment of distal radius fracture.Methods The clinical data were retrospectively analyzed from the patients with distal radius fractures treating with manual reduction and plaster fixation or small splintfixation from January 2007 to December 2008 （No telephone follow-up,group A,n =64） and from January 2009 to December 2010 （Telephone follow-up,group B,n =71）.And group B received the telephone follow-up during the first week after discharge,then,follow-up was taken by the condition of patients.Then,the fracture healing situation and Gartland-Werley wrist score were observed.Results All patients were followed up 19 months on average.There were 9 cases in group A and 2 cases in group B who had loss of fracture reduction,but showed no significant difference （x^2 =5.688,P =0.017） between two groups in incidence.Fracture healing was achieved.There were no significant differences（t =1.396,P =0.165）in fracture healing time between group A [（10.4-± 1.8）weeks] and group B [（10.9 ±2.8） weeks].Significant differences was found in the palmar tilt angle,the radial inclination angle and the radial length between the two group （t =3.268,2.216,2.692,respectively;P 〈0.05）.At last follow-up,According to the Gartland-Werley score,the results were excellent in group B than that in group A （Z =-1.994,P =0.046） between two groups.Conclusions Distal radial fracture patients by telephone follow-up can prevent loss of reduction and guide the rehabilitation training for patients with satisfactory results.