伸直型橈骨遠端骨折37例正骨復位的臨床分析

Clinical analysis of bone-setting manipulation in 37 cases of extension type distal radial fracture

目的探討正骨治療伸直型橈骨遠端骨折的臨床療效。方法回顧性分析2015年1月~2017年12月鏡湖醫院中醫科閉合正骨復位、小夾板外固定治療的伸直型橈骨遠端骨折病例共37例。正骨後要求帶夾板進行早期腕關節功能鍛煉,並從尺偏角、掌傾角、腕關節Gartland-Werley功能評分觀測歸納分析。結果正骨後當天尺偏角、掌傾角分別是:22.39±3.06,12.35±1.97;6~8周尺偏角、掌傾角分別是22.63±1.66,12.46±1.46。測定值與正常均值比較差異無統計學意義(P>0.05)。術後6個月内Gartland-Werley腕關節功能評分優32例,良4例,可1例。結論正骨復位、小夾板外固定法應用於治療伸直型橈骨遠端骨折效果明顯,治療方法比較簡單,方便、快捷、價廉,適合門急診推廣。

Objective To investigate the clinical effect of bone-setting manipulation in the treatment of extended distal radius fracture.Methods From January 2015 to December 2017,37 cases of extended distal radius fracture treated by bone-setting manipulation and external fixation with small splints at TCM department of Kiang Wu hospital were analyzed retrospectively.Under the condition of splint fixation,early wrist functional exercises are required after bone-setting treatment.Ulnar deviation,palmar inclination and Gartland-Werley scores of wrist function are summarized and analyzed.Results The ulnar deviations and palmar inclinations were respectively 22.39±3.06 and 12.35±1.97.on the day after treatment;6-8 weeks later,the relative ulnar deviations and palmar inclinations were respectively 22.63±1.66.and 12.46±1.46.There was no significant difference between the measured values and the normal mean values(P>0.05).6 months after,the Gartland-Werley scores of wrist function showed that 32 cases were excellent,4 cases were good and 1 case was acceptable.Conclusion Bone-setting manipulation and external fixation with small splints are effective in the treatment of extended distal radius fractures,which is simple,convenient,fast and inexpensive,and suitable for outpatient and emergency application.