手法复位配合经皮穿针治疗桡骨远端骨折的效果观察

Clinical Effect of Manual Reduction and Percutaneous Pinning in the Treatment of Distal Radius Fracture

目的:研究手法复位+经皮穿针在桡骨远端骨折中的价值。方法:选取2020年9月-2022年1月景德镇市中医医院收治的60例桡骨远端骨折患者,按照随机数字表法将其分为对照组和研究组,每组30例。研究组开展手法复位+经皮穿针,对照组实施手法复位石膏外固定。比较两组疗效、并发症发生情况、腕关节功能评分(Cooney)、生活质量(SF-36)评分、尺偏角、掌倾角、桡骨轴向短缩长度。结果:研究组优良率为90.00%,高于对照组的63.33%,差异有统计学意义(P<0.05)。研究组并发症发生率为6.67%,低于对照组的33.33%,差异有统计学意义(P<0.05)。术前,两组疼痛、功能状态、活动度、背伸/掌屈活动度、握力评分比较,差异均无统计学意义(P>0.05);术后4周,研究组疼痛、功能状态、活动度、背伸/掌屈活动度、握力评分均高于对照组,差异均有统计学意义(P<0.05)。术前,两组尺偏角、掌倾角、桡骨轴向短缩长度比较,差异均无统计学意义(P>0.05);术后4周,研究组尺偏角高于对照组,但掌倾角低于对照组,桡骨轴向短缩长度短于对照组,差异均有统计学意义(P<0.05)。术前,两组各维度SF-36评分比较,差异均无统计学意义(P>0.05);术后4周,研究组各维度SF-36评分均高于对照组,差异均有统计学意义(P<0.05)。结论:手法复位+经皮穿针的疗效更为突出,快速改善患者腕关节功能,并发症少,促进病情好转,提升患者生活质量。

Objective:To study the clinical value of manual reduction and percutaneous pinning in the treatment of distal radius fracture.Method:A total of 60 distal radius fracture patients treated in Jingdezhen City TCM Hospital from September 2020 to January 2022 were selected,patients were divided into control group and study group according to random number table,30 cases in each group.The study group was treated with manual reduction and percutaneous pinning;the control group was treated with manual reduction and plaster external fixation.Efficacy,complications,wrist function score(Cooney),quality of life(SF-36)score,ulnar angle,palmaral angle and radial axial shortening length were compared between two groups.Result:The excellent and good rate of the study group was 90.00%,which was higher than 63.33%of the control group,the difference was statistically significant(P<0.05).The incidence of complications of the study group was 6.67%,which was lower than 33.33%of the control group,the difference was statistically significant(P<0.05).Before surgery,there were no significant differences in pain,functional status,range of motion,dorsiflexion/palm flexion range and grip strength scores between two groups(P>0.05);4 weeks after surgery,pain,functional status,range of motion,dorsiflexion/palm flexion range and grip strength scores of the study group were higher than those of the control group,the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in ulnar angle,palmaral angle and radial axial shortening length between two groups(P>0.05);4 weeks after surgery,the ulnar angle of the study group was higher than that of the control group,but the palmaral angle of the study group was lower than that of the control group,and the radial axial shortening length of the study group was shorter than that of the control group,the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in SF-36scores of all dimensions between two groups(P>0.05);4 weeks after surgery,SF-36 scores of all dimensions of the study group were higher than those of the control group,the differences were statistically significant(P<0.05).Conclusion:The therapeutic effect of manual reduction and percutaneous pinning is more outstanding,which can quickly improve the wrist function of patients with fewer complications,promote the improvement of the condition and improve the quality of life of patients.