手法整复、高分子夹板固定配合中药外敷治疗老年桡骨远端骨折的临床观察

Observation on treating distal radius fractures by manual reduction,polymer splints plus external application of TCM

目的:观察应用手法整复、高分子夹板外固定配合经验方中药散剂外敷治疗老年桡骨远端骨折的临床效果。方法:选取我院75例老年桡骨远端骨折住院患者,随机分为观察组39例和对照组36例,观察组患者行中医手法整复、高分子夹板固定配合我院经验方中药散剂外敷治疗;对照组行中医手法复位加高分子夹板固定治疗。观察两组骨折愈合时间、骨折愈合后腕关节功能评分、愈合过程中桡骨远端骨折愈合评分系统(RUSS)评分及临床疗效。结果:观察组骨折平均愈合时间为(27.7±3.2)天,明显短于对照组的(39.7±4.1)天,P<0.05。骨折愈合后,观察组Gartland-Werley评分、PRWE评分与对照组比较,差异均有统计学意义(P<0.05)。观察组第2周、4周、6周RUSS评分均高于对照组(P<0.05);第8周RUSS评分与对照组比较,差异无统计学意义(P>0.05)。观察组总有效率为97.4%,对照组为77.8%,两组比较,差异有统计学意义(P<0.05)。结论:桡骨远端骨折行中医手法复位、高分子夹板外固定并配合我院中药外敷散剂治疗,可有效促进骨折愈合,提高伤后功能评分,临床应用前景广阔,值得进一步临床研究。

Objective:To observe the effects of manual reduction,polymer splints plus external application of TCM on distal radius fractures in the elderly.Methods:75cases were randomly divided into the observation group(39cases)and control group(36cases).The observation group was treated by manual reduction,polymer splints plus external application of TCM;the control group was treated by manual reduction plus polymer splints.The fracture healing time,the wrist function score after fracture healing,the RUSS score and the effects in groups were observed.Results:The average healing time was(27.7±3.2)days in the observation group,and significantly shorter than(39.7±4.1)days in the control group(P<0.05).The differences in the Gartland-Werley score and the PRWE score between groups were significant(P<0.05).The RUSS scores in the observation group were higher than those in the control group after treatment for2weeks,4weeks and6weeks(P<0.05);there was no significant difference between groups in8weeks(P>0.05).The total efficiency was97.4%in the observation group and77.8%in the control group,with a statistically significant difference(P<0.05).Conclusion:The manual reduction,polymer splints plus external application of TCM on distal radius fractures in the elder can effectively promote fracture healing,improve the postoperative injury score,and is worthy of further clinical research.