手法复位夹板外固定联合中药熏洗和切开复位钢板内固定治疗骨质疏松性桡骨远端骨折疗效对比

Comparison of efficacy of manual reduction and splinting immobilization plus TCM medicine fumigation and open reduction plus internal fixation on osteoporotic distal radius fractures

目的:比较手法复位夹板外固定联合中药熏洗和切开复位钢板内固定治疗骨质疏松性桡骨远端骨折的疗效。方法:回顾性分析2019年1月-2020年6月68例骨质疏松性桡骨远端骨折患者病历资料,其中手法复位夹板外固定联合中药熏洗(夹板组)32例,切开复位钢板内固定(钢板组)36例。比较两组骨折疼痛缓解时间,骨折愈合时间,治疗6个月后两组患者掌倾角、尺偏角和桡骨高度、腕关节活动度、Robbins腕关节评分及并发症发生情况。结果:夹板组骨折愈合时间及疼痛缓解时间显著短于钢板组(P<0.05),治疗6个月后夹板组掌倾角、尺偏角、桡骨高度均小于钢板组(P<0.05)。两组Robbins腕关节评分,腕关节活动度,前臂活动度比较差异无统计学意义(P>0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论:切开复位钢板内固定治疗老年骨质疏松性桡骨远端骨折在骨折复位方面优于手法复位夹板外固定联合中药熏洗组,但骨折愈合时间及疼痛缓解时间长于后者,在功能恢复及安全性方面两者无显著差异。

Objective:To observe comparison of efficacy of manual reduction and splinting immobilization plus traditional Chinese medicine fumigation and open reduction and internal fixation on osteoporotic distal radius fractures.Methods:The medical records of 68 patients with osteoporotic distal radius fractures from January 2019 to June 2020 were retrospectively analyzed.Among them,32 cases were given manual reduction and splinting immobilization plus traditional Chinese medicine fumigation(the splint group),36 cases were given openreductionplusinternalfixation(the steel plate group).Results:The fracture healing time and pain relief time of the splint group were significantly shorter than the steel plate group(P<0.05).After 6 months of treatment,the palm inclination,ulnar deviation and radius height in the splint group were all smaller than the steel plate group(P<0.05).There was no significant difference in Robbins wrist score,wrist range of motion,and forearm range of motion between the two groups(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conlcusion:Open reduction plus internal fixation on elderly osteoporotic distal radius fractures are superior in fracture reduction,but the fracture healing time and pain relief time are longer,and there is no significant difference between the two in terms of functional recovery and safety.