老年骨质疏松性桡骨远端Colles骨折手法整复后小夹板固定联合独活寄生汤的治疗效果

Therapeutic effect of small splint fixation combined with Duhuo Jisheng decoction after manual reduction of elderly osteoporotic distal radius colles fractures

目的老年骨质疏松性桡骨远端Colles骨折手法整复后小夹板固定联合独活寄生汤对疼痛、肿胀、骨折愈合及腕关节功能活动的影响。方法收集2011年6月~2015年6月在我院住院或门诊治疗过的老年骨质疏松性桡骨远端Colles骨折的96例患者,按照随机分组法分为对照组和观察组各48例,两组均给予常规治疗,在此基础上对照组手法整复后采用小夹板固定治疗,观察组采用小夹板固定联合独活寄生汤治疗,记录两组患者用药前、用药后第3、5、10、15天患侧周径及疼痛变化情况,并计算第15天肿胀及疼痛的缓解率;治疗后第2周、第4周、第6周、第8周行X线检查后骨折愈合评分系统(RUSS)评价两组患者骨折愈合情况;腕关节功能活动情况在骨折愈合后采用Gartland-Werley、PRWE评价。结果与用药前比较,用药后肿胀及疼痛较前明显好较,第15天评价肿胀及疼痛的缓解率分别为(92.28±2.56)%及(82.78±4.21)%(P<0.01);观察组RUSS评分第6周起高于对照组,观察组老年骨质疏松性桡骨远端Colles骨折(8.07±0.43)周愈合,明显短于对照组愈合时间(11.61±0.36)周(P<0.01);Gartland-Werley、PRWE评分结果显示观察组腕关节功能活动恢复效果明显优于对照组(P<0.01)。结论小夹板固定联合独活寄生汤治疗老年骨质疏松性Colles骨折手法整复后的效果明显,可有效缓解患者肿胀,去除疼痛,对加强骨折愈合及患侧肢体功能康复均有显著作用。

Objective To observe the effect of small splint fixation combined with duhuo Jisheng Decoction on pain, swelling, fracture healing and wrist function after manual reduction of elderly osteoporotic distal radius Colles fractures. Methods A total of 96 patients with elderly osteoporotic distal radius Colles fractures who were hospitalized in our department or treated in the outpatient clinic in our hospital from June 2011 to June 2015 were selected. According to the randomized grouping method, the patients were divided into the control group and the observation group, with 48 cases in each group. Both groups were given conventional therapy. On the basis of this, the control group was treated with small splint fixation after manual reduction, and the observation group was treated with small splint fixation combined with Duhuo Jisheng decoction. The changes of affected side circumference and pain were recorded before administration and 3, 5, 10 and 15 days after administration in both groups. The remission rate of swelling and pain was calculated on day 15; the recovery of fractures of both groups was evaluated via fracture healing scoring system（RUSS） after X-ray at 2 weeks, 4 weeks, 6 weeks and 8 weeks after treatment; wrist function and activity were assessed by Gartland-Werley and PRWE after fracture healing. Results Compared with that before administration, swelling and pain after administration were significantly improved. The remission rates of swelling and pain were （92.28±2.56）% and （82.78±4.21）% （P〈0.01） respectively on day 15; the RUSS score in the observation group was higher than that in the control group from the sixth week, The healing time of elderly osteoporotic distal radius Colles fractures in the observation group was（8.07±0.43） weeks, which was significantly shorter than that of（11.61±0.36） weeks in the control group（P〈0.01）; Gartland- Werley and PRWE scores showed that the healing effect of wrist function and activity in the observation group was sig nificantly better than that in the control group（P〈0.01 ）. Conclusion The effect of small splint fixation combined with Duhuo Jisheng decoction after manual reduction of elderly osteoporotic distal radius Colles fractures is significant, which can effectively relieve swelling and remove pain, and have significant effect on strengthening fracture healing and rehabilitation of affected limb function.