中医手法整复联合石膏外固定术治疗旋后外旋型踝关节骨折100例

One Hundred Cases of Supination External Rotation Ankle Fracture Treated with TCM Manipulative Reduction in Combination with Plaster External Fixation

目的:观察中医手法整复联合石膏外固定术治疗旋后外旋型踝关节骨折的临床疗效。方法:将200例患者随机分为手术组和保守组,每组各100例。保守组采用手法整复石膏外固定治疗,手术组采用切开复位内固定治疗。采用Mazur标准评定踝关节功能;通过X线片观察骨折复位和移位情况;同时对两组患者住院天数与住院费用进行比较。结果:保守组优良率为87.0%,手术组优良率为37.0%,两组患者优良率比较,差异有统计学意义(χ2=22.075,P<0.05)。保守组治疗4周、6周、12周后骨痂生长评判评分低于手术组,两组比较,差异具有统计学意义(P<0.05)。保守组住院天数、住院费用均低于手术组,两组比较,差异均有统计学意义(P<0.05)。结论:踝关节骨折脱位旋后-外旋型Ⅲ、Ⅳ度采用保守治疗与手术治疗均能达到很好的治疗效果,但保守治疗安全系数高,经济费用低,能减少患者的医疗费用。

Objective： To observe the clinical curative effect of TCM manipulative reduction in combination with plaster external fixation on supination external rotation ankle fracture. Methods： Two hundred patients were randomly divided into the operation group and the conservative group,with 100 cases in each group. The conservative group was treated with manipulative reduction and plaster external fixation,and the operative group was treated with open reduction and internal fixation. The ankle function was evaluated by Mazur standard; The reduction and displacement of the fracture were observed by X-ray; Meanwhile,the hospitalization days and hospitalization expenses of the two groups were compared. Results： The excellent rate of the conservative group was87%,while that of the operation group was 37%,and the difference between the two groups was statistically significant（ χ2=22. 075,P〈0. 05）. The scores of callus growth in the conservative group after 4,6 and 12 weeks＇ treatment respectively were all lower than those in the operation group,and all the differences between the two groups were statistically significant（ P〈0. 05）.The hospitalization days and hospitalization expenses of the conservative group were lower than those of the operation group,and the difference between the two groups was statistically significant（ P〈0. 05）. Conclusion： Ankle fracture dislocation,both the conservative treatment and surgical treatment can have a remarkable clinical curative effect supination external rotation type Ⅲ andⅣ,but the conservative treatment with high safety factor and low economic cost can reduce the patient＇s medical expenses.