3D打印夹板固定结合中医治疗在桡骨远端骨折的临床研究

Clinical Study of 3D Printed Splint Fixation and Traditional Chinese Medicine in the Treatment of Distal Radius Fracture

目的:探讨3D打印夹板固定结合中医中药联合治疗在桡骨远端骨折患者中的应用效果。方法:选择2018年8月-2020年5月因外伤致桡骨远端骨折且在本科室自愿保守治疗的患者60例作为研究对象,随机分为普通夹板固定组(n=30)和3D打印夹板固定组(n=30)。普通夹板固定组采取普通夹板固定结合中医中药联合治疗方法,3D打印夹板固定组则采用3D打印夹板固定结合中医中药联合治疗。评估两组治疗效果,比较两组腕关节Gartland-Werley评分(GW评分),比较临床愈合后掌倾角、尺偏角、桡骨高度及患肢肿胀评分。结果:治疗后,3D打印夹板固定组掌倾角、尺偏角、桡骨高度均优于普通夹板固定组(P<0.05)。3D打印夹板固定组治疗总有效率高于普通夹板固定组,差异无统计学意义(P>0.05)。治疗后第1、2周,两组患肢肿胀评分比较差异无统计学意义(P>0.05);第4、8周,3D打印夹板固定组患肢肿胀评分低于普通夹板固定组(P<0.05)。治疗后第4、8周,3D打印夹板固定组腕关节功能GW评分低于普通夹板固定组(P<0.05)。结论:将3D打印夹板固定,结合中医中药联合治疗用于桡骨远端骨折患者,使患者治疗后对掌倾角、尺偏角、桡骨高度恢复更加精确,有效提高患者愈合效果,减少骨折畸形愈合不良状况的发生,减少患肢肿胀,提高了治疗效果,值得推广应用。

Objective:To explore the application effect of 3D printed splint fixation combined with traditional Chinese medicine in the treatment of patients with distal radius fractures.Method:From August 2018 to May 2020,60 patients with distal radius fractures due to trauma and voluntary conservative treatment in our department were selected as the research objects,and randomly divided into the ordinary splint fixation group(n=30)and the 3D printed splint fixation group(n=30).The ordinary splint fixation group adopted common splint fixation combined with traditional Chinese medicine treatment method,and the 3D printed splint fixation group adopted 3D printed splint fixation combined with traditional Chinese medicine treatment.Evaluated the effect of the two groups,compared the Gartland-Werley(GW)scores of wrist joint of the two groups,and compared the palm dip angle,ulnar deviation angle,radius height after healing and swelling score of affected limbs.Result:After treatment,the palm dip angle,ulnar deviation angle,radius height of the 3D printed splint fixation group were better than those of the ordinary splint fixation group(P<0.05).The total effective rate of the 3D printed splint fixation group was higher than that of the ordinary splint fixation group,and the difference was not statistically significant(P>0.05).At 1,2 weeks after treatment,there was no significant difference in the swelling score of the affected limb between the two groups(P>0.05),at the 4th and 8th weeks,the swelling score of the affected limb in the 3D printed splint fixation group was lower than that in the ordinary splint fixation group(P<0.05).At the 4th and 8th weeks after treatment,the GW score of wrist joint function in the 3D printed splint fixation group was lower than that in the ordinary splint fixation group(P<0.05).Conclusion:The 3D printed splint fixation combined with traditional Chinese medicine is used to treat patients with distal radius fractures,so that the patients can more accurately recover the palm dip angle,ulnar deviation angle,radius height after treatment,effectively improve the healing effect of patients,and reduce poor healing of fracture deformities and swelling of the affected limbs,and improves the treatment effect,which is worthy of popularization and application.