正骨理筋法结合可调节生物力学夹板治疗桡骨远端骨折的临床研究

Clinical study of bone-setting and tendon-regulation manipulation combined with adjustable biomechanical splint in treating distal radius fractures

目的探讨正骨理筋法结合可调节生物力学夹板治疗桡骨远端骨折的疗效,以期为临床决策的制定提供参考。方法选取河南省骨科医院2020年1月—2021年2月收治的桡骨远端骨折患者74例作为研究对象,按照随机数字表法分为对照组和治疗组,每组37例。2组患者均给予手法整复措施,之后给予对照组患者可调节生物力学夹板治疗,夹板拆除后给予患者常规康复训练;治疗组患者在对照组基础上于夹板拆除后给予郭氏正骨“五步理筋法”治疗。比较2组患者治疗前后的掌倾角、尺偏角;观察并比较2组患者骨折固定期间的并发症发生情况;比较2组患者的骨折愈合时间及疗效。结果治疗前,2组患者桡骨远端的尺偏角、掌倾角比较,差异均无统计学意义(P>0.05);治疗后,2组患者桡骨远端的尺偏角、掌倾角明显增加,且治疗组大于对照组,差异均有统计学意义(P<0.05)。治疗组患者骨折固定期间的并发症发生率为2.70%,对照组为10.80%,二者比较,差异无统计学意义(P>0.05)。治疗组患者的骨折愈合时间为(11.47±1.81)周,少于对照组的(13.33±1.95)周,差异有统计学意义(P<0.05)。治疗组患者的骨折愈合总有效率为97.30%,高于对照组的78.38%,差异有统计学意义(P<0.05)。结论正骨理筋法结合可调节生物力学夹板治疗桡骨远端骨折的疗效明显,有助于腕关节功能恢复,且能促进骨折愈合,值得在临床推广使用。

Objective This paper aims to investigate the efficacy of bone-setting and tendon-regulation manipulation combined with the adjustable biomechanical splint in treating distal radius fractures to provide evidence for clinical decision-making.Methods Seventy-four patients with distal radius fractures admitted to Henan Provincial Orthopedic Hospital from January 2020 to February 2021 were selected as the study participants.They were assigned to the control group and the treatment group following a random number table,with 37 cases in each group.Patients in both groups were given manual reduction measures,followed by adjustable biomechanical splint treatment in the control group,and conventional rehabilitation training after splint removal.Patients in the treatment group were given Guo's bone-setting"five-step tendon-regulation"treatment after splint removal based on the control group.The palmar inclination angle and ulnar deviation angle before and after treatment were compared between the two groups;the complications during fracture fixation were observed and compared between the two groups;time to fracture healing and therapeutic efficacy were compared between the two groups.Results Before treatment,there was no significant difference in ulnar deviation angle and palmar inclination angle between the two groups(P>0.05);after treatment,the ulnar deviation angle and palmar inclination angle of the distal radius were significantly increased in the two groups,and the treatment group was significantly greater than the control group(P<0.05).No significant difference was observed in the incidence of complications during fracture fixation between the treatment group and the control group(2.70%vs.10.80%;P>0.05).The time to fracture healing of the treatment group was significantly shorter than that of the control group[(11.47±1.81)weeks vs.(13.33±1.95)weeks,P<0.05].The overall response rate of fracture healing in the treatment group was significantly higher than that in the control group(97.30%vs.78.38%,P<0.05).Conclusion The treatment of distal radius fracture with bone-setting and tendon-regulation manipulation combined with the adjustable biomechanical splint is conducive to the recovery of wrist joint function and promoting fracture healing.These advantages hold promise for a wider application clinically.