折顶回旋整复联合黄油纱外敷治疗儿童桡骨远端背靠背骨折临床研究

Treatment of Children’s Back to Back Fracture of Distal Radius with Folding Top and Whirling Reduction Combined with External Application of Butter Gauze

目的总结折顶回旋手法整复联合黄油纱外敷夹板固定治疗儿童桡骨远端背靠背骨折的疗效及可行性。方法 2012年7月~2018年6月,采用折顶回旋手法整复联合黄油纱外敷夹板固定治疗儿童桡骨远端背靠背骨折30例(治疗组),选取同期30例采用折顶回旋整复夹板外固定的桡骨远端背靠背骨折患儿(对照组)相比较。比较两组患者治疗过程中消肿效果、末次随访腕部功能评价及治疗过程中发生的严重并发症。结果全部患儿都得到了随访,骨折达到骨性愈合的标准,无外观畸形,未出现严重并发症。根据《中药新药临床研究指导原则》的消肿效果标准进行评价:治疗组有效率:93.33%,对照组有效率:83.33%,比较有统计学差异(p<0.05)。Moed等功能评价结果,治疗组优良率:96.67%,对照组优良率:90.00%,比较有统计学差异(p<0.05)。结论折顶回旋手法整复联合黄油纱外敷夹板固定治疗儿童桡骨远端背靠背骨折具有良好的消肿效果,功能恢复优良,治疗费用低,并发症少,值得临床推广。

Objective:To summarize the curative effects and feasibility of the treatment of children’s back-to-back fracture of distal radius with folding top and whirling manipulation combined with external application of butter gauze splint. Methods:From July 2012 to June 2018, 30 children with distal radius back-to-back fracture were treated with folding top rotary reduction combined with external application of butter gauze splint fixation(treatment group), and 30 children with distal radius back-to-back fracture treated with folding top rotary reduction splint external fixation(control group) were selected for comparison. The detumescence effect, wrist function evaluation at the last follow-up and serious complications during the treatment were compared between the two groups. Results:All the children were followed up, the fracture reached the standard of bone healing, no appearance deformity, no serious complications. According to the Guiding Principles for Clinical Research of Chinese Medicine, the effective rate of the treatment group was 93.33%, and that of the control group was 83.33%, with statistical difference(p < 0.05). The excellent and good rate of the treatment group was 96.67%, the excellent and good rate of the control group was 90.00%, the difference was statistically significant(p < 0.05). Conclusion:The treatment of children’s distal radius back-to-back fracture with folding top maneuver combined with external application of butter gauze splint fixation has good swelling reducing effect, excellent functional recovery, low treatment cost and few complications, which is worthy of clinical promotion.