桃红四物汤联合冰硝散外敷对孟氏骨折伴桡神经损伤患儿肘关节功能和桡神经功能的影响

Effects of Taohong Siwu Tang(桃红四物汤)combined with external application of Glauber’s salt on elbow joint function and radial nerve function in children with Monteggia fracture with radial nerve injury

目的观察桃红四物汤联合冰硝散外敷对孟氏骨折伴桡神经损伤患儿肘关节功能和桡神经功能的影响。方法选取2016年2月至2021年4月唐山市第二医院小儿骨科收治的38例孟氏骨折伴桡神经损伤的患儿,采用随机数字表法分为治疗组和对照组,各19例。所有患儿均采用尺骨切开复位钢板内固定联合探查肱桡关节治疗,并实施桡神经探查,在肘关节呈屈曲位时使用克氏针固定肱桡关节,石膏固定肘关节,4周后拆除克氏针,撤出外固定后进行药物治疗。对照组予冰硝散外敷,治疗组在对照组治疗方法的基础上联合桃红四物汤口服。2组均治疗4周后统计肘关节功能,6个月后统计桡神经功能恢复情况。结果治疗组肘关节功能优良率为94.74%(18/19),显著高于对照组的68.42%(13/19),2组比较,差异有统计学意义(P<0.05)。对照组桡神经功能优良率为89.47%(17/19),治疗组为94.74%(18/19),2组比较,差异无统计学意义(P>0.05)。对照组和治疗组骨折愈合时间分别为(51.86±6.89)d、(51.34±6.78)d,2组比较,差异无统计学意义(P>0.05)。治疗组桡骨小头脱位率为0,明显低于对照组的15.79%(3/19),2组比较,差异有统计学意义(P<0.05)。结论桃红四物汤联合冰硝散外敷治疗孟氏骨折伴桡神经损伤患儿疗效满意,可有效改善肘关节和桡神经功能,缩短骨折愈合时间,减少桡骨小头脱位发生,值得临床推广应用。

Objective To observe the effects of Taohong Siwu Tang(桃红四物汤)combined with external ap-plication of Glauber’s salt on elbow joint function and radial nerve function in children with Monteggia fracture with radial nerve injury.Methods Thirty-eight children with Monteggia fracture accompanied by radial nerve injury ad-mitted to the Department of Pediatric Orthopedics of the Second Hospital of Tangshan from February 2016 to April 2021 were selected and divided into a treatment group and a control group,each with 19 cases,using a randomized numerical table method.All children were treated with ulnar osteotomy and reduction plate internal fixation com-bined with exploration of the humerus-radius joint,and radial nerve exploration was implemented.The humerus-radi-us joint was fixed with Kirschner’s pin when the elbow joint was in the flexed position,and the elbow joint was fixed with a plaster cast,and the Kirschner’s pin was removed after 4 weeks,and the treatment was carried out after the external fixation was withdrawn.The control group was treated with external application of Glauber’s salt,and the treatment group was treated with Taohong Siwu Tang on the basis of the treatment method of the control group,and the recovery of elbow joint function and radial nerve function of the two groups was counted after 4 weeks of treat-ment.Results The excellent rate of elbow joint function in the treatment group was 94.74%(18/19),which was significantly higher than that of 68.42%(13/19)in the control group,and the difference between the two groups was statistically significant(P<0.05).The excellent rate of radial nerve function in the control group was 89.47%(17/19),and 94.74%(18/19)in the treatment group,and the difference was not statistically significant when comparing the excellent rate of radial nerve function in the 2 groups(P>0.05).The fracture healing time of the con-trol group and the treatment group were(51.86±6.89)days and(51.34±6.78)days respectively,the difference between the 2 groups was not statistically significant(P>0.05);the rate of radial tuberosity dislocation in the treat-ment group was 0,which was significantly lower than that of the control group(15.79%)(3/19),and the differ-ence was statistically significant in the comparison of the 2 groups(P<0.05).Conclusion The efficacy of Taohong Siwu Tang combined with external application of Glauber’s salt in the treatment of Monteggia fracture with radial nerve injury in children is satisfactory,which can effectively improve the function of elbow joint and radial nerve,shorten the healing time of fracture,and reduce the incidence of dislocation of radial tuberosity,which is worthy of clinical popularization and application.