梯形垫小夹板与石膏固定治疗粉碎性Colles骨折的病例对照研究

Case control study on small splint fixation with trapezoid pad and plaster slab fixation for the treatment of commin uted Colles fracture

目的：比较梯形垫配合小夹板与传统石膏外固定治疗粉碎性Colles骨折的临床疗效.方法：自2010年10月至2012年3月,80例粉碎性Colles骨折患者,年龄23～92岁,分成梯形垫夹板治疗组和管形石膏对照组,各40例.治疗组男13例,女27例,平均年龄（62.1±19.2）岁;对照组男15例,女25例,平均年龄（60.2±19.5）岁.两组患者均采用手法复位治疗后,对照组用传统管形石膏固定,治疗组用梯形垫结合小夹板固定.两组定期摄X线片复查及换药至骨折临床愈合,拆除夹板后指导功能锻炼.两组患者参照Gartland-Werley腕关节功能评分标准分别在拆除夹板当天和2个月后进行评分,并观察X线下桡骨愈合后与复位后相比的短缩长度.结果：腕关节功能评分：治疗组拆除夹板当天和2个月后Gartland Werley平均得分分别为8.1±2.8和5.3±4.5,对照组为10.3±2.6和8.4±5.8,对照组评分高于治疗组;桡骨短缩长度：治疗组（4.8±1.7）mm,对照组（8.2±2.1）mm,对照组短缩大于治疗组.结论：梯形垫配合小夹板固定治疗粉碎性Colles骨折比传统管形石膏固定效果更可靠,疗效更好.

Objective：To compare the clinical efficacy of trapezoid pad coordinate with small splint fixation treatment with plaster slab fixation treatment for comminuted Colles fracture.Methods：From October 2 010 to March 2012,80 outpatients with comminuted Colles fracture were divided into two groups.There were 40 patients in trapezoid pad splint fixation treatment group and 40 patients in pipe type plaster control group.There were 13 males and 27 females in trapezoid pad splint fixation treatment group,with an average age of （62.1±19.2） years old.And there were 15 males and 25 females in pipe type plaster control group,with an average age of （60.2±19.5） years old.After treated with manipulative reduction,the fractures were fixed with pipe plaster in the control group,and were fixed with trapezoid pad joint by small splint in the tre atment group.The patients in both groups were regularly taken X-ray recheck and changed dressings to obta in the clinical healing.Patients were guided to do functional exercise after splints were taken off.The therapeutic effects were evaluated according to Gartland-Werlley wrist score when splints taken off and after 2 months.Results：According to wrist score,the average scores in the treatment group were （8.1±2.8） when splints taken off and （5.3±4.5） after 2 months.And the average scores in the control group were （10.3±2.6） when splints taken off and （8.4±5.8） after 2 months.The score in the treatment group was higher than that of control group.The average shortened lengths of radius were （4.8±1.7） mm in the treatment group and （ 8.2±2.1） mm in the control group.The shortened length of control group was larger than that of treatment group.Conclusion：Trapezoid pad coordinated with small splint fixation is better than traditional pipe type plaster for treating comminuted Colles fracture.