手法复位小夹板外固定结合微动理念锻炼治疗肱骨干骨折

Manipulative reduction and small splint fixation combined with micromovement exercise for treatment of humeral shaft fractures

目的 ：探讨正骨手法复位小夹板外固定结合微动理念锻炼治疗肱骨干骨折的临床疗效。方法 ：自2011年3月至2014年2月,采用手法复位小夹板外固定治疗肱骨干骨折患者64例,男28例,女36例;年龄22-67岁,平均38.1岁。按AO/OTA分型：A1型10例,A2型12例,A3型11例;B1型10例,B2型12例,B3型7例;C1型2例,C2型1例,C3型1例。整复后配合微动理念早期功能锻炼。患者均不合并其他部位骨折和血管神经损伤,均无严重内科疾病。随访观察患者骨折愈合及肩肘关节功能恢复情况,并评定疗效。结果：所有患者获随访,时间10-12个月,平均10.3个月。2例复位后3个月少量骨痂生长,改为手术治疗;2例复位后出现桡神经症状,改为手术治疗,其他患者骨性愈合时间8-12周,平均10.2周,骨折达到骨性愈合后,按照Constant-Murley肩关节功能评分评定疗效,平均（93.5±3.2）分,优29例,良29例,可6例,优良率90.3%;按照Mayo肘关节功能评分标准（MEPS）,平均（93.7±4.2）分,优35例,良23例,可6例,优良率91.9%。结论 ：正骨手法复位小夹板外固定结合微动理念锻炼治疗肱骨干骨折,具有其相应的科学基础和实用价值,整复效果好,费用低廉,能够有效减少并发症,促进患者功能康复。

Objective：To investigate the therapeutic efficacy of bone setting manipulative reduction and small splint fixation combined with micro movement theory exercise for treatment of humeral shaft fractures. Methods：From March 2011 to February 2014,64 cases of humeral shaft fractures were treated by bone setting manipulative reduction and small splint fixation including 28 males and 36 females with an average age of 38.1 years old ranging from 22 to 67 years old. According to the classification of AO / OTA,there were 10 cases of type A1,12 cases of type A2,11 cases of type A3,10 cases of type B1,12 cases of type B2,7 cases of type B3,2 cases of type C1,1 case of type C2,1 case of type C3. After close reduction early functional exercise performed according to micro movement theory. All patients had no other parts of the fractures, neurovascular injury,and serious medical problems. Patients were followed up for fracture healing,shoulder and elbow joint function recovery,and curative effect. Results：All patients were followed up from 10 to 12 months with an average of 10.3 months. Of them,2 cases had a small amount of callus growth at 3 months after close reduction,so instead of operation;2 cases appeared radial nerve symptoms after close reduction,so instead of operation. Other patients were osseous healing,the time was 8 to 12 weeks with an average of 10.2 weeks. After osseous healing,according to Constant-Murley score system,the average score was（93.5±3.2）points,the result was excellent in 29 cases,good in 29 cases,fair in 6 cases,excellent and good rate was 90.3%;according to the Mayo score system,the average score was（93.7±4.2） points,the result was excellent in 35 cases,good in 23 cases,fair in 6cases,excellent and good rate was 91.9%. Conclusion：Bone setting manipulative reduction and small splint fixation combined with micromovement theory exercise for treatment of humeral shaft fractures has advantage of positive effect,easy and inexpensive method,the treatment has relevant scientific basis and practical value,it can effectively reduce complications,promote patients early recovery.