解剖型纸质支架夹板治疗Colles骨折的临床观察

Clinical Effect Analysis of Anatomical Type Paper Splint in Treatment of Colles Fracture

目的:通过比较柳木夹板、塑形纸质支架夹板、解剖型纸质支架夹板固定Colles骨折的治疗效果,从而分析解剖型纸质支架夹板治疗Colles骨折的临床疗效。方法:选取63例Colles骨折患者,通过手法复位后予柳木夹板、塑形纸质支架夹板、解剖型纸质支架夹板固定的患者分别分为A,B,C 3组,测量3组患者治疗前、治疗后24h,1周,3周和6周的标准正侧位X片掌倾角、尺偏角和桡骨高度,3个月后进行Dienst腕关节功能评分,评价解剖型纸质支架夹板治疗Colles骨折的临床疗效。结果:63例患者经治疗后骨折均获骨性愈合。经治疗6周后3组患者影像学表现均显著优于治疗前;治疗后1周解剖型纸质支架夹板组掌倾角、尺偏角恢复优于其余两种夹板,差异有统计学意义(P<0.05),治疗后1周,3周解剖型纸质支架夹板组桡骨高度恢复优于其余两组,差异有统计学意义(P<0.05);治疗后6周解剖型纸质支架夹板组桡骨高度恢复优于其余两组,差异有统计学意义(P<0.01)。结论:手法复位后使用3种夹板固定均能显著改善桡骨远端患者的影像学表现,较好地改善掌倾角与尺偏角,较好地维持桡骨高度;解剖型纸质支架夹板维持桡骨高度效果更好且腕关节功能恢复更优。

Objective： To analyze the clinical effect of anatomical paper splint by comparing of willow splint, plastic paper splint and anatomical paper splint in the treatment of Colles fracture. Methods： A total of 63 cases of Colles fracture trea- ted with manipulative reduction and fixtion of willow splint, plastic paper splint and anatomical paper splint patients were divided into A, B, C group. The patients of 3 groups were measured the standard anteroposterior and lateral X-ray of the palmar tilt, ulnar inclination and radial height before treatment and 24 h, 1 weeks, 3 weeks and 6 weeks after treatment. Dienst wrist function score was performed to evaluate the clinical effect of anatomical paper splint in the treatment of Col- les fracture after 3 months. Results.- Bone healing was achieved in 63 patients after treatment. After 6 weeks treatment, the imaging results of the 3 groups were significantly better than those before treatment. After 1 weeks treatment, palmar tilt, ulnar deviation recovery in anatomical paper splint group was better than those in other 2 groups （P〈0, 05）. 1 and 3 weeks after the treatment, the radial height restoration in anatomical paper splint group is better than those in the other two groups, the difference was statistically significant （P〈0.05） ; 6 weeks after the treatment, the radial height restora- tion in anatomical paper splint group is better than those in the other two groups, the difference was statistically signifi- cant （P〈0.01）. Conclusions; After manual reduction, 3 kinds of splint can significantly improve imaging performance with better palmar angle, ulnar inclination and radial height in distal radius fracture patients. Anatomic paper splint is better to maintain the radial height and the wrist function is better.