Meta-analysis of the efficacy of volar plate internal fixation versus closed reduction and external fixation in the treatment of adult distal radius fractures

Objective:To compare the efficacy of open reduction and volar locking plate internal fixation with closed reduction and external fixation in the treatment of distal radius fractures by using meta analysis.Methods:The databases of CNKI,Wanfang,Weipu,Chinese biomedical literature,Pubmed,Embase,and Cochrane Library were retrieved,and the randomized controlled studies that directly compared the efficacy of plate internal fixation and closed reduction external fixation in the treatment of distal radius fractures published publicly from the establishment of the database to April 2023 were collected.The two researchers independently screened the retrieved literature according to the inclusion and exclusion criteria,extracted data,used Cochrane risk bias assessment tool for quality assessment,and used RevMan 5.4 software for meta analysis.Results:A total of 10 randomized controlled trials were included,all of which were in English.There were 1042 patients in total,and 9 of them were rated as low risk.Meta analysis results showed that one year after the treatment of distal radius fracture with volar locking plate internal fixation,DASH score[MD=-5.64,95%CI(-7.21,-4.06),P<0.00001];One year later,PRWE score[MD=-5.90,95%CI(-8.88,-2.92),P=0.001];Palm flexion[MD=5.92,95%CI(1.29,10.55),P=0.01];Pronation[MD=2.48,95%CI(0.59,4.36),P=0.01];Postrotation[MD=4.73,95%CI(2.15,7.31),P=0.0003];Grip strength[MD=0.61,95%CI(0.12,1.10),P=0.02];palmar tilt angle[MD=9.84,95%CI(5.66,14.02),P<0.00001];Radial inclination[MD=4.33,95%CI(2.97,5.69),P<0.00001]was superior to closed reduction plaster or splint external fixation.One year later,the European Five dimensional Health Scale(EQ-5D-5L)score[MD=0.02,95%CI(-0.01,0.05),P=0.27];Back extension[MD=2.22,95%CI(-4.15,8.59),P=0.49];Ulnar deviation[MD=3.49,95%CI(-0.80,7.78),P=0.11];Radial deviation[MD=2.05,95%CI(-2.39,6.50),P=0.37];Ulnar variance[MD=-1.14,95%CI(-3.16,0.88),P=0.27];There was no significant difference in complications[MD=0.77,95%CI(0.54,1.10),P=0.16](P>0.05).Conclusion:Based on the current clinical data,internal fixation with volar locking plate is more conducive to mid-term DASH score and grip strength recovery than closed reduction plaster or splint external fixation,but there is no significant difference in the quality of life and complications of patients.For adult distal radius fractures,surgical indications should be carefully grasped,and non operative treatment should be given priority.

Value of negative pressure sealing drainage on wound healing of Gustilo IIIB and IIIC open fractures

BACKGROUND Gustilo III fractures have a high incidence and are difficult to treat.Patients often experience difficulty in wound healing.Negative pressure drainage technology can help shorten wound healing time and has positive value in improving patient prognosis.AIM To explore the clinical value of the negative pressure sealing drainage technique in wound healing of Gustilo IIIB and IIIC open fractures.METHODS Eighty patients with Gustilo IIIB and IIIC open fractures with skin and soft tissue injuries who were treated in the Second People’s Hospital of Dalian from March 2019 to December 2021 were selected as the research subjects.They were divided into a study group(n=40,healed with negative pressure closed drainage)and a control group(n=40,healed with conventional dressing changes)according to the variation in the healing they received.The efficacy of the clinical interventions,the variations in the regression indicators(time to wound healing,time to fracture healing,time to hospitalization),and the conversion and healing of bacterial wounds were compared 1-3 mo after the intervention.RESULTS The total effective rate of patients among the study group was 95.00%(38/40),which was notably higher than 75.00%(30/40)among the control group(P<0.05).The wound healing time,fracture healing time,and hospital stay of the patients in the study group was shorter than the control group(P<0.05).After the intervention,the negative bacterial culture at the wound site rate and wound healing rate of the patients among the study group increased compared to the control group(P<0.05).CONCLUSION Negative pressure sealing and drainage technology has a good therapeutic effect on patients with Gustilo IIIB and IIIC open fracture wounds with skin and soft tissue injury.It can notably enhance the wound healing rate and the negative rate of bacteria on the wound surface and help to speed up the recovery process of patients.

Four Pins Assisted Reduction of Complex Segmental Femoral Fractures: a Technique for Closed Reduction

Complex segmental femoral fractures are usually not amenable to closed reduction. The purpose of this study was to evaluate a series of patients who had undergone four pins assisted reduc- tion and intramedullary nail fixation to determine the therapeutic effect of this closed reduction tech- nique. Between December 2010 and January 2013, 15 consecutive patients with segmental femoral fractures were treated with four pins assisted reduction at our hospital. The patient was placed in a supine position on a radiolucent fracture table and a. gentle traction was attempted on the limb. Usu- ally, the proximal fracture segment exhibited the typical deformity of flexion, external rotation, and abduction, the middle segment exhibited adduction and distal fracture segment exhibited flexion. Four Schanz pins were placed percutaneously to fix one cortex and did not penetrate into the me- dullary cavity, and the ＂T＂ sharp handles were fixed on the Schanz pins. The fragments were then re- duced by reversing the deforming forces for segmental fractures by two assistants~ And then, the re- duction could be easily achieved and intramedullary nail fixation was performed. Radiographs were evaluated for the quality of the reduction and fracture union. Closed reduction was achieved in all pa- tients using the four pins technology. All 15 fractures united uneventfully. No patient had a rotational malunion or limb length discrepancy at the time of the last follow-up. Thirteen of the fifteen （86.7%） patients had anatomic reduction and two of them （13.3%） had minor varus alignment of 3° and 5°. Knee stiffness was Observed in 2 patients and no implant failure was observed. Surgical treatment of complex segmental femoral fractures With four pins assisted reduction and intramedullary nail fixation techniques can result in excellent reductions and a high union rate.

Radial nerve recovery following closed nailing of humeral shaft fractures without radial nerve exploration: A retrospective study

BACKGROUND Radial nerve palsy due to humeral shaft fracture is the most common peripheral nerve injury associated with long bone fractures.An antegrade nailing surgical technique is becoming popular for the fixation of these fractures with minimal invasiveness.We analyzed nerve recovery in patients with humeral shaft fracture and radial nerve palsy treated with humeral nail fixation without nerve exploration.AIM To assess the radial nerve recovery rate and time from humeral shaft fracture with surgical treatment using close nailing.METHODS We retrospectively collected data of patients who underwent undergone surgical nail fixation for humeral shaft fractures between October 1,2016,and March 31,2020.Subsequently,we analyzed the primary or secondary radial nerve palsy recovery rate and radial nerve motor function recovery time.RESULTS The study included 70 patients who underwent surgical treatment for closed-or Gustilo type I open humeral shaft fractures using a nail fixation technique without radial nerve exploration.The patients suffered from primary(n=5)and secondary(n=5)radial nerve palsy.A 100%radial nerve recovery rate was achieved.The mean recovery time was 4.3 mo.CONCLUSION The study results indicate full recovery of radial nerve palsies from humeral shaft fracture using close nailing treatment.Surgeons need not be concerned about the occurrence of permanent nerve palsies.

Modified Closed Reduction and Percutaneous Kirschner Wires Internal Fixation for Treatment of Supracondylar Humerus Fractures in Children

Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children.Methods From February 2015 to August 2019,73 patients with Gartland’s type II and III supracondylar fractures were treated with this modified method.Totally,68 of all patients were followed up for 3–12 months(mean 8.25 months).The evaluation results included fracture nonunion,ulnar nerve injury,pin track infection,carrying angle and elbow joint Flynn score.Results The results showed that bone union was observed in all children,one case had an iatrogenic ulnar nerve injury,and the symptoms were completely relieved in 4 months after removing of the medial-side pin.All children had no cubitus varus deformity and no pin track infection,and the rate of satisfactory results according to Flynn’s criteria score was 100%.Conclusion The modified closed reduction and Kirschner wires internal fixation could effectively reduce the rate of open reduction,the risk of iatrogenic ulnar nerve injury,and the incidence of cubitus varus deformity in treatment of supracondylar humerus fractures in children.

Epidemiological Pattern of Closed Femoral Shaft Fractures in a Regional Tertiary Hospital in Enugu, Nigeria

Background: The femur is the longest and strongest tubular bone in the human body. The femoral shaft is the portion of the bone between 5 cm distal to the lesser trochanter and 6 cm proximal to the most distal point of the medial femoral condyle. Femoral shaft fractures often result from high energy forces. These fractures occur mostly among young adults. Objective: This was to determine the epidemiological pattern of closed femoral shaft fractures in a regional tertiary hospital in Enugu, Nigeria. Method: The study was a prospective study over a 12 month period (June 2015-May 2016) at National Orthopaedic Hospital, Enugu. Following ethical approval and written informed consent, patients were consecutively recruited. The patients were clinically and radiographically evaluated at presentation. The diagnosis of closed femoral shaft fractures were made from the physical examination finding of absent open wound communicating with the fracture hematoma in the thigh and anteroposterior (AP) and lateral x-rays of the affected thigh confirming the fracture pattern. The data collected included patients’ demographics, the cause of injury, the side of injury and anatomic site of the injury among other parameters. The data were collected using well designed and structured proforma. Results: A total of 52 femoral shaft fractures in 50 patients were included and analyzed using SPSS version 20.0. The age range of the patients is 18 - 85 years with a median age of 39.1 ± 14.9 years. The most commonly affected age group is 21 - 30 years. There was male preponderance with a male to female ratio of 2.3:1. Majority of the fractures (76.9%) resulted from road traffic crashes most commonly following motor vehicular accident (36.5%). Majority of the fractures (92.3%) are unilateral with right side to left side ratio of 1.2:1. Majority of the patients (51.9%) had Winquist Hansen grade III type of fracture. The most common associated injury is fractures of tibia/fibula followed by fracture of the neck of the ipsilateral femur. All the patients were treated operatively using either locked intramedullary nailing technique or plating technique. Majority of the patients (59.6%) were discharged between 10th and 29th day post-operatively. Conclusion: From the results of this study, it is concluded that most of the closed femoral shaft fractures were caused by high energy trauma from road traffic crashes. It is therefore recommended that proper education of motorists on good use of roads and strict adherence to traffic rules will significantly help in preventing the occurrence of these fractures in our environment.

Closed reduction of hip dislocation associated with ipsilateral lower extremity fractures:A case report and review of the literature

BACKGROUND Traumatic hip dislocation usually occurs following high-velocity trauma.It is imperative that the dislocation be reduced in a timely manner,especially in a closed manner,as an orthopedic emergency.However,closed reduction can hardly be achieved in patients who also have ipsilateral lower extremity fractures.Herein,we focus on hip dislocation associated with ipsilateral lower extremity fractures,excluding intracapsular fractures(femoral head and neck fractures),present an early closed hip joint reduction method for this injury pattern,and review the literature to discuss the appropriate closed reduction technique for this rare injury pattern.CASE SUMMARY We report a case of a 37-year-old male who sustained a left acetabular posterior wall fracture,an ipsilateral comminuted subtrochanteric fracture and dislocation of the hip.The hip dislocation was reduced urgently in a closed manner using the joy-stick technique with a T-shaped Schanz screw.The fractures were reduced and fixed as a 2nd-stage surgery procedure.At the 17-month postoperative follow-up,the patient had full range of motion of the affected hip.CONCLUSION Closed reduction of a hip dislocation associated with ipsilateral lower extremity fractures is rarely achieved by regular maneuvers.Attempts at closed reduction,by means of indirectly controlling the proximal fracture fragment or reconstructing the femoral leverage rapidly with the aid of various external reduction apparatuses,were shown to be effective in some scenarios.Mandatory open reduction is indicated in cases of failed closed reduction,particularly in irreducible dislocations.

CLOSED REDUCTION AND PERCUTANEOUS K-WIRES FIXATION OF DISPLACED SUPRACONDYLAR HUMERUS FRACTURES IN CHILDREN

To observe the effects of closed reduction and percutaneous K wires fixation of displacd supracondylar humerus fracture in children MethodsRetrospective review of fourteen patients who sustained displaced supracondylar fracture of distal humerus treated by closed reduction and percutaneous K wires fixation Results. All patients’ K wires were removed at 4 weeks post operation Their elbow function regained at 8 weeks The average period of followed up was 10 month (varies from 6 to 18 month), all fractures healed very well without any permanent complications Two transient nerves palsy,ulnar and radial nerve each, recovered completely at 12 weeks and 16 weeks post operation respectively Conclusion. Closed reduction and percutaneous K wires fixation is a safe and efficient treatment for displaced humerus surpracondylar fracture in children

Treatment of Displaced Mid-Clavicle Fractures by Closed Titanium Elastic Nail

Introduction: Recently, intramedullary nailing for displaced middle third fractures of clavicle has received wide attention. Though open nailing has been widely described, closed nailing finds less mention. This paper therefore aims to study the outcome of closed titanium elastic nailing for displaced mid-clavicular fractures. Material and Methods: This was a prospective study of 34 patients with displaced middle third clavicle fracture who underwent closed intramedullary nailing with titanium elastic nail at a tertiary care centre. The operative time, length of incision, time for radiological union, pain and functional outcome after union were noted. Results: The mean operative time was 34.33 mins. The mean time of discharge was 2.25 days. The average time of radiological union was 10.23 weeks. All the patients achieved full, painless range of motion of the ipsilateral shoulder. The average Constant-Murley score at 12 months was 94.28 indicating excellent result. Conclusion: Closed titanium elastic nailing offers a safe and minimally invasive method of fixation for fractures of middle-third clavicle with excellent functional outcome.

Thrombelastography and color Doppler flow imaging in the perioperative period after closed lower limb fracture

Objective To observe the changes of thrombelastography (TEG) and color Doppler flow imaging (CDFI) in the perioperative period after closed lower limb fracture.Methods Fasting venous blood samples in the morning from 11 healthy adults were used

Comparison of three kinds of treatment for pediatric closed femoral shaft fracture

To compare and evaluate 3 kinds of treatments of pediatric closed femoral shaft fractures.Methods Seventy-nine patients were divided into 3 groups and treated using hip spica casting after skeletal traction,unilateral multifunctional fixation and plate fixation.The result were evaluated according to clinical function,time to union,complications,radiology examination and the economic cost.Results Both time to union and economic cost of the external fixation group were shorter than that of the skeletal traction group and plate fixation group.Conclusion The unilateral multi-functional external fixation is an ideal solution to pediatric close femoral shaft fractures.7 refs,3 tabs.

Anisotropic characteristics of electrical responses of fractured reservoir with multiple sets of fractures

In fractured reservoirs, the fractures not but also form the main flow channels which connect productivity of reservoirs. However, because of the only provide the storage space for hydrocarbons, the pores of the matrix, so fractures dominate the heterogeneity and randomness of the distribution of fractures, exploration and evaluation of fractured reservoirs is still one of the most difficult problems in the oil industry. In recent years, seismic anisotropy has been applied to the assessment of fractured formations, whereas electrical anisotropy which is more intense in fractured formations than seismic anisotropy has not been studied or used so extensively. In this study, fractured reservoir models which considered multiple sets of fractures with smooth and partly closed, rough surfaces were established based on the fractures and pore network, and the vertical and horizontal electrical resistivities were derived as a function of the matrix and fracture porosities according to Ohm＇s law. By using the anisotropic resistivity equations, variations of the electrical anisotropy of three types of fractured models under the conditions of free pressure and confining pressure were analyzed through the variations of the exerted pressure, matrix porosity, fracture aperture and formation water resistivity. The differences of the vertical and horizontal resistivities and the anisotropy between the connected and non-connected fractures were also analyzed. It is known from the simulated results that an increase of the confining pressure causes a decrease of electrical anisotropy because of the elasticity of the closed fractures and the decrease of the fracture aperture. For a fixed fracture porosity, the higher the matrix porosity, the weaker the electrical anisotropy in the rock formation.

Diagnosis,treatment and complications of radial head and neck fractures in the pediatric patient

Radial head and neck fractures represent up to 14%of all pediatric elbow fractures and can be a difficult challenge in the pediatric patient.In up to 39%of proximal radius fractures,there is a concomitant fracture,which can easily be overlooked on the initial standard radiographs.The treatment options for proximal radius fractures in children range from non-surgical treatment,such as immobilization alone and closed reduction followed by immobilization,to more invasive options,including closed reduction with percutaneous pinning and open reduction with internal fixation.The choice of treatment depends on the degree of angulation and displacement of the fracture and the age of the patient;an angulation of less than 30 degrees and translation of less than 50%is generally accepted,whereas a higher degree of displacement is considered an indication for surgical intervention.Fractures with limited displacement and non-surgical treatment generally result in superior outcomes in terms of patient-reported outcome measures,range of motion and complications compared to severely displaced fractures requiring surgical intervention.With proper management,good to excellent results are achieved in most cases,and long-term sequelae are rare.However,severe complications do occur,including radio-ulnar synostosis,osteonecrosis,rotational impairment,and premature physeal closure with a malformation of the radial head as a result,especially after more invasive procedures.Adequate follow-up is therefore warranted.

闭合复位弹性髓内钉治疗股骨骨折患儿的临床效果

目的探讨闭合复位弹性髓内钉治疗股骨骨折患儿的临床效果。方法选取2019年5月至2022年5月贵州省人民医院小儿外科收治的70例股骨骨折患儿,按照随机数字表法分为对照组与观察组,每组各35例。对照组采用切开复位接骨板内固定术治疗,观察组采用闭合复位弹性髓内钉治疗。比较两组治疗效果及手术相关指标。结果两组总有效率比较,差异无统计学意义(P>0.05)。观察组术中出血量少于对照组,手术时间、骨折愈合时间、住院时间均短于对照组(P<0.05)。结论闭合复位弹性髓内钉治疗股骨骨折患儿的临床效果确切,可减少术中出血量,缩短手术时间、骨折愈合时间、住院时间,值得临床推广应用。

F型钳辅助复位在股骨干骨折手术中的临床应用

目的:探讨辅助复位工具F型钳在股骨干骨折复位中的临床疗效。方法:回顾性分析2019年1月至2021年12月采用髓内钉内固定手术治疗的45例股骨干骨折患者,根据复位方法不同分为两组。观察组21例,男15例,女6例;年龄27~92(53.38±18.81)岁;左侧9例,右侧12例;骨折AO分型,A型7例,B型8例,C型6例;受伤至手术时间7~13(4.62±3.34)d;采用F型钳辅助复位。对照组24例,男17例,女7例;年龄20~92(51.96±20.43)岁;左侧12例,右侧12例;骨折AO分型,A型11例,B型8例,C型5例;受伤至手术时间2~13(6.29±3.04)d;采用传统复位方式。比较两组手术时间、术中出血量、术中透视次数、术中切开复位比例、骨折临床愈合时间、术后并发症、住院时间、住院费用,并于术后6、12个月采用膝关节Lysholm评分进行临床疗效评价。结果:所有患者获得随访,时间12~24(16.60±3.45)个月。观察组手术时间、术中出血量、术中透视次数、切开复位例数、骨折临床愈合时间分别为(58.19±7.93)min、(88.10±44.45)ml、(25.29±5.54)次、0例、(4.76±0.77)个月,对照组分别为(79.33±22.94)min、(222.92±144.45)ml、(47.46±26.25)次、5例、(7.13±1.80)个月,两组比较差异有统计学意义(P<0.05)。两组术后并发症、住院时间及住院费用比较,差异无统计学意义(P>0.05)。术后6个月观察组膝关节Lysholm评分(88.62±4.48)分,优于对照组(79.21±8.91)分(F=21.948,P=0.000);两组术后6个月支撑物使用、疼痛、下蹲评分比较,差异无统计学意义(P>0.05)。术后12个月观察组膝关节Lysholm评分中爬楼梯、疼痛评分(9.62±1.20)、(19.76±1.92)分,优于对照组(7.83±2.04)、(21.88±2.88)分(P<0.05);两组其他项目评分及总分比较,差异无统计学意义(P>0.05)。结论:F型钳器械操作简单,易学易用,与传统的复位方法相比,在股骨干骨折复位中,能缩短手术时间,减少术中出血量,降低术中透视次数,加快骨折临床愈合,使膝关节获得更加早期的功能恢复。

非常规致密油储层压裂增能一体化技术分析

针对试验区非常规致密油储层常规缝网压裂改造体积有限,压后递减快、稳产差,采出程度低的问题,采用压裂增能一体化工艺,从平衡压力、提高缝控体积及保持能量入手,总结出“补、压、闷、控”的技术思路,通过前置补充能量、增大裂缝与储层接触面积、闷井扩散压力、控制返排等方式,达到压裂增能一体化的目的。现场实施效果表明,采用多级暂堵技术改造体积提高1倍以上,闷井扩散25~30d,无效返排率降低近15个百分点,达到了入井液保持地层能量的目的。与以往单井缝网压裂、整体缝网压裂相比,增油强度分别提高0.27t/(d·m)、0.34t/(d·m);压后前3个月平均单井日增油3.0t,是同期甜点压裂和整体压裂的1.2倍和1.8倍,提产效果显著。结合现场实施及效果分析,优化完善参数设计,形成压裂增能一体化设计原则。

肘关节造影闭合复位经皮克氏针固定治疗儿童肱骨外髁骨折

目的探讨肘关节造影闭合复位经皮克氏针固定治疗儿童肱骨外髁骨折的疗效。方法采用肘关节造影闭合复位经皮克氏针固定治疗24例肱骨外髁骨折患儿。记录骨折愈合情况、并发症发生情况、肘关节恢复情况,末次随访时采用Flynn肘关节评分标准评价疗效。结果患儿均获得随访,时间18~24个月。骨折均愈合,时间8~16周。术后未发生肘外翻畸形、肱骨外髁缺血性坏死、骨化性肌炎、缺血性肌挛缩以及神经症状等并发症。末次随访时,4例患儿肘关节功能未完全恢复正常,但不影响生活,Flynn肘关节评分等级均为良;20例肘关节功能均恢复至健侧水平,Flynn肘关节评分等级均为优。结论采用肘关节造影闭合复位经皮克氏针固定治疗儿童肱骨外髁骨折,术中能清楚显示儿童肱骨远端的软骨成分,有助于判断骨折的移位程度和闭合复位的质量,避免不必要的切开复位及并发症的发生。

闭合复位克氏针髓内固定和交叉固定治疗儿童桡骨远端骨折的效果对比

目的:探讨闭合复位克氏针髓内固定和交叉固定治疗儿童桡骨远端骨折的效果。方法:选取2020年5月—2023年3月江西省儿童医院外科收治的80例桡骨远端骨折患儿的临床资料进行回顾研究,按照克氏针固定方式的不同分为两组。髓内固定组(n=40)进行闭合复位克氏针髓内固定,交叉固定组(n=40)进行闭合复位克氏针交叉固定。比较两组近期疗效、手术指标、恢复指标、骨折畸形愈合和骨折再移位发生情况、腕关节功能[腕关节患者自评量表(patient-rated wrist evaluation,PRWE)、Dienst功能评分]及术后并发症发生情况。结果:术后4周,两组患儿尺偏角、掌倾角、桡骨缩短长度均得到明显改善,髓内固定组尺偏角、掌倾角均大于交叉固定组,桡骨缩短长度短于交叉固定组(P<0.05)。两组手术时间、术中出血量、术中透视次数、住院时间、治疗费用、骨折畸形愈合率、优良率、并发症发生率比较,差异均无统计学意义(P>0.05)。髓内固定组骨折愈合时间短于交叉固定组,骨折再移位发生率低于交叉固定组(P<0.05)。髓内固定组术后2、4、8周PRWE评分均低于交叉固定组(P<0.05)。结论:在儿童桡骨远端骨折中,闭合复位克氏针髓内固定治疗的近期效果优于交叉固定,可增加稳定性并加快骨折愈合,但两种置针方式的安全性并无统计学差异。

郑氏手法整复结合夹板中立板外固定治疗儿童桡骨远端骨骺骨折

目的:探讨郑氏手法整复结合夹板中立板外固定治疗儿童桡骨远端骨骺骨折的手法操作及其临床疗效。方法:2022年3月~2023年9月收治的桡骨远端骨骺骨折患儿46例,采取郑氏手法整复结合夹板中立板外固定治疗。复位前、复位后即刻、复位后6月测量腕关节桡骨高度、桡骨掌倾角、桡骨尺偏角,采用Gartland-Welley评估量表评价腕关节功能,记录患者压疮、张力性水泡、皮肤红疹、骨折不愈合、骨筋膜室综合征、压迫性神经麻痹等并发症发生情况。结果:复位后即刻测量桡骨高度为10.71±2.25mm,桡骨掌倾角为12.84±3.63°,桡骨尺偏角为22.47±4.31°,均较复位前明显改善,差异有统计学意义(P<0.05)。复位后6月患者Gartland-Werley腕关节功能评分总分显著低于复位前,差异有统计学意义(P<0.05)。且主观评价、客观评价、残余畸形、并发症得分四项指标均明显低于复位前,差异有统计学意义(P<0.05)。根据Gartland-Welley评分结果:优39例,良7例,优良率为100%。结论:郑氏手法整复结合夹板中立板外固定治疗儿童桡骨远端骨骺骨折具有复位成功率高、临床疗效突出、安全性高、并发症少的特点,值得临床推广应用。

手法复位夹板外固定和闭合骨折复位内固定治疗儿童闭合性肱骨髁上骨折的效果对比研究

对比手法复位夹板外固定和闭合骨折复位内固定治疗儿童闭合性肱骨髁上骨折的效果。选取2020年1月—2021年12月广东省佛山市中医院收治的242例闭合性肱骨髁上骨折患儿为研究对象,根据治疗方法的不同将患儿分为两组,分别为对照组(n=52)和观察组(n=190)。对照组患儿接受手法复位夹板外固定手术治疗,观察组患儿接受闭合骨折复位内固定手术治疗,比较两组患儿治疗效果。结果显示,观察组患儿各项关节功能评分均高于对照组(P<0.05),并发症总发生率低于对照组(P<0.05),疼痛评分低于对照组(P<0.05),住院时间短于对照组(P<0.05)。研究发现,在儿童闭合性肱骨髁上骨折手术治疗中,闭合骨折复位内固定手术治疗法所取得的治疗效果显著优于手法复位夹板外固定治疗法,其更有助于改善患儿关节功能,预防并发症的出现,减轻患儿疼痛感,促进患儿骨折愈合。