指套牵引联合手法复位外固定治疗老年桡骨远端骨折的临床效果

Study on the curative effect of finger-trap traction combined with manual reduction and external fixation in the treatment of elderly distal radius fractures

目的:对比指套牵引联合手法复位外固定与单纯手法复位外固定治疗老年桡骨远端骨折的临床疗效。方法:选取2022年3月—2023年3月于天津大学天津医院就诊的老年桡骨远端骨折患者1000例,以随机数字表法均分为指套牵引联合手法复位组和单纯手法复位组。在手法复位后2 d、1周、2周、4周、8周、12周及20周对两组患者的腕关节活动度、疼痛评分、Gartland-Werley腕关节功能评分进行比较。结果:排除脱落病例后,指套牵引联合手法复位组纳入487例,手法复位组491例。相比于单纯手法复位,指套牵引联合手法复位显著提升了背伸(P=0.024)、尺偏(P<0.001)、掌屈(P=0.003)活动度,降低了复位8周(P<0.001)、12周(P=0.022)、20周(P=0.002)时患者的Gartland-Werley腕关节功能评分,但没有显著抑制随访期中患者的主观疼痛。结论:指套牵引联合手法复位外固定可部分地提高老年桡骨远端骨折患者复位后腕关节的活动度及功能。

Objective To compare the clinical effect of finger-trap traction combined with manual reduction external fixation with manual reduction external fixationalone in the treatment of elderly distal radius fractures.Methods Aged patients with distal radius fracture treated in Tianjin Hospital of Tianjin University from March 2022 to March 2023 were selected and divided into two groups:finger-trap traction combined with manual reduction group and manual reduction group by random number table method.Wrist range of motion,pain and Gartland-Werley wrist score were compared between the two groups at 2 days,1 week,2 weeks,4 weeks,8 weeks,12 weeks and 20 weeks after manual reduction.Results There were 487 cases in the finger-trap traction combined with manual reduction group and 491 cases in the manual reduction group.Compared with manual reduction alone,finger-trap traction combined with manual reduction significantly improved the range of motion of dorsiflexion(P=0.024),ulnar deviation(P<0.001)and palmarflexion(P=0.003).The Gartland-Werley wrist function scores at 8 weeks(P<0.001),12 weeks(P=0.022),and 20 weeks(P=0.002)were decreased,but did not significantly inhibit subjective pain ofpatient during follow-up.Conclusion The finger-trap traction combined with manual reduction external fixation can partially improve the range of motion and function of wrist joint in elderly patients with distal radius fracture.