桡骨远端骨折小夹板固定后轴向移位的观察

Axial displacement of distal radius fractures after external fixation with traditional Chinese splint

[目的]探讨桡骨远端骨折小夹板固定后轴向移位对腕关节功能的影响。[方法]2019年1月-2019年10月手法复位小夹板固定后桡骨轴向移位患者45例,依据复位后3个月末次随访时桡骨远端轴向移位程度分为<2.5 mm组24例,身2.5 mm组21例。采用Mayo评分评价腕关节功能。测量两组末次随访时X线片桡骨短缩移位程度、掌倾角及尺偏角。[结果]3个月以上的末次随访时两组间Mayo评分的两组疼痛评分差异无统计学意义(P>0.05),但是<2.5 mm组在功能、握力、活动范围及Mayo总分方面均显著优于多2.5 mm组,差异均有统计学意义(P<0.05)。末次随访时<2.5 mm组的轴向移位、掌倾角、尺偏角均显著优于在15 mm组(P<0.05)。[结论]桡骨远端骨折小夹板固定后存在桡骨轴向移位现象,其轴向移位<2.5mm对腕关节功能影响较小。

[Objective]To investigate the effect of axial displacement on clinical outcomes of distal radius fractures fixed with traditional Chinese splints.[Methods]From January 2019 to October 2019,45 patients received manual reduction and external fixation with traditional Chinese splint for distal radial fractures.Based on the radial axial displacement at the latest follow up,24 patients fall into the<2.5mm group,while 21 patients were in the≥2.5 mm group.Wrist function was assessed by using Mayo score,additionally,the extent of radius shortening displacement,palmar tilt and radial angle on radiographs were measured and compared between the two groups at the last follow-up.[Results]At the last follow-up of more than 3 months,there was no significant difference in the Mayo pain subscore between the two groups(P>0.05),but the<2.5 mm group was significantly superior to the≥2.5 mm group in terms of function,grip strength,range of motion subscores and the total Mayo score,with statistical significances(P<0.05).At the last follow-up,the<2.5 mm group proved significantly superior to the≥2.5 mm group in terms of axial displacement,palmar tilt and radial angle(P<0.05).[Conclusion]Axial displacement of the distal radius occurred after traditional splint fixation,however,the axial displacement<2.5 mm has little effect on wrist joint function.