小夹板固定与石膏固定治疗桡骨远端骨折的临床疗效对比

田兵 蒋乙兵 杨波 黄三廷 帅奇 王宏

摘 要：目的 对比手法整复小夹板固定与石膏外固定治疗桡骨远端骨折的臨床疗效。方法 选择2015年9月～2017年9月我院骨科收治的桡骨远端骨折患者60例，随机分成小夹板组与石膏外固定组，各30例。所有患者采用手法整复，小夹板组应用小夹板固定，石膏外固定组采用石膏固定，观察两组患者患肢掌倾角、尺偏角和桡骨高度及腕关节功能情况。结果 60例患者均获得随访，随访时间6～24个月。末次随访X线片显示，小夹板组患者掌倾角、尺偏角和桡骨高度恢复情况均优于石膏外固定组患者，组间比较，差异具有统计学意义（P<0.05）；小夹板组患者手术优良率93.33%，高于石膏外固定组的76.66%，差异具有统计学意义（P<0.05）。结论 手法整复小夹板固定治疗桡骨远端骨折较石膏外固定临床疗效好更优，小夹板复位丢失发生情况低于石膏外固定，肿胀消退、骨折愈合后功能优于石膏固定。

关键词：桡骨远端骨折；手法整复；小夹板固定；石膏外固定

中图分类号：R683.7 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.14.035

文章编号：1006-1959（2018）14-0118-02

Abstract：Objective To compare the clinical effect of manual reduction splint fixation and plaster external fixation in the treatment of distal radius fracture.Methods From September 2015 to September 2017，60 patients with distal radius fracture were randomly divided into splint group and plaster external fixation group，30 cases each.All patients were treated by manual reduction，splint group was fixed with small splint and plaster fixation was used in the plaster external fixation group.The palmar angle of the limbs，the angle of ulnar，the height of the radius and the function of the wrist were observed in the two groups.Results All 60 patients were followed up for 6 to 24 months.The last follow-up X-ray showed that the degree of palm tilt，ulnar deviation and tibia height recovery in the splint group were better than those in the external plastering group，the difference was statistically significant（P<0.05）.The excellent and good rate of operation in the small splint group was 93.33%，which was higher than that in the external plastering group 76.66%，the difference was statistically significant（P<0.05）.Conclusion The treatment of distal radius fracture by manual reduction and splint fixation is better than that of plaster external fixation.The incidence of reduction and loss of small splint is lower than that of plaster external fixation，and the swelling subsides，and the function after fracture healing is better than that of plaster fixation.

Key words：Distal fracture of radius

桡骨远端骨折（distal fracture of radius）是临床上比较常见的骨折，损伤发生率约占临床所见骨折的17%[1]。在中老年人群中，女性患者明显多于男性，随着年龄的增加，其发生率逐步上升，低能量损伤远超高能量损伤发生率，其发生多与高龄、绝经后骨质疏松密切相关。腕关节功能活动要求较高，桡骨远端骨折失治、误治易导致腕关节慢性疼痛、创伤性关节炎与关节僵硬，严重者将影响腕、手部功能。我院骨科对比2015年9月～2017年9月采用手法整复小夹板外固定与石膏外固定治疗桡骨远端骨折疗效，为临床上选择提供依据，现报告如下。

1 资料与方法

1.1一般资料 选择2015年9月～2017年9月铜仁市中医院骨伤科60例桡骨远端骨折患者的资料，所有骨折均为新鲜骨折，受伤至治疗时间均小于3 d且为闭合损伤。采用数字随机分配原则将其分为小夹板固定组和石膏外固定组各30例。其中小夹板固定组男13例，女17例，年龄30～76岁，平均年龄（54.91±13.12）岁，骨折AO分型：A型16例，B型11例，C型3例。石膏外固定组男11例，女19例，年龄29～74岁，平均年龄（56.3±12.9）岁，骨折AO分型：A型17例，B型9例，C型4例。两组患者性别、年龄、骨折AO分型等资料比较，差异无统计学意义（P>0.05），临床可比。