中医手法复位治疗不稳定型桡骨远端骨折的临床疗效分析

发布时间：2018-01-01 14:35

本文关键词：中医手法复位治疗不稳定型桡骨远端骨折的临床疗效分析　出处：《新疆医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:观察手法复位夹板固定与切开复位内固定治疗不稳定型桡骨远端骨折的临床疗效,通过对不稳定型桡骨远端骨折的两种不同治疗方案的比较,研究它们对不稳定型桡骨远端骨折的临床疗效,为选择治疗方案提供依据。方法:选取2014年12月-2015年12月,在新疆医科大学第四附属医院骨科住院治疗的骨折患者,根据诊断、纳入和排除标准,筛选出符合要求的76例为研究对象,根据患者及家属的选择分为手法复位夹板固定组(治疗组)和切开复位内固定组(对照组),每组38例。两组患者首次就诊时均行腕关节标准X线正侧位检查,利用Rizzo诊断标准定义不稳定型桡骨远端骨折,Stewart改良评分详细测量数据,并根据AO分型标准将其分为:治疗组A3型:4例,B型:23例,C型:11例,对照组A3型:3例,B型:24例,C型:11例。术后分别于2、4、8、12周复诊及随访,收集相关影像学和腕关节评分数据。并用SPSSl7.0软件进行统计分析,比较不同治疗方法对不稳定型桡骨远端骨折的疗效差异。结果:所有患者均获得随访,随访时间3个月,两组患者X线显示全部愈合。对照组对纠正桡骨短缩的作用显著高于治疗组(P0.05),但对恢复腕关节正常解剖角度及功能与治疗组的差别无统计学意义(P0.05)。结论:两种治疗方案治疗不稳定型桡骨远端骨折均可达到满意疗效,手法复位夹板固定虽未能达到解剖复位,但腕关节功能不受限制。手法复位治疗复杂的不稳定型桡骨远端骨折易再次移位,畸形愈合风险较高,且功能恢复较差。
[Abstract]:Objective: to observe the clinical effect of manual reduction and splint fixation and open reduction and internal fixation in the treatment of unstable distal radius fractures. To study the clinical effects of unstable distal radius fractures and provide evidence for the choice of treatment. Methods: from December 2014 to December 2015. According to the criteria of diagnosis, inclusion and exclusion, 76 cases of fracture treated in orthopedic department of 4th affiliated Hospital of Xinjiang Medical University were selected as research objects. According to the choice of patients and their families, they were divided into two groups: manual reduction and splint fixation group (treatment group) and open reduction and internal fixation group (control group). 38 cases in each group. The patients in both groups were examined with standard X-ray and lateral position of wrist joint at the first visit. The unstable distal radius fracture was defined by Rizzo diagnostic criteria. The data of Stewart improved score were measured in detail. According to AO classification criteria, the patients were divided into treatment group (A3 type: 4 cases, B type: 23 cases, type C: 11 cases, control group, type A3: 3 cases, 3 cases). Twenty-four cases of type B: type C: 11 cases were followed up for 12 weeks after operation. The data of imaging and wrist score were collected and analyzed by SPSSl7.0 software. Results: all patients were followed up for 3 months. The effect of the control group on correcting the short radius contraction was significantly higher than that of the treatment group (P 0.05). But there was no significant difference in the recovery of normal anatomical angle and function between the treatment group and the treatment group (P 0.05). Conclusion: the treatment of unstable distal radius fractures can achieve satisfactory results. Manual reduction and splint fixation failed to achieve anatomic reduction, but the wrist function was not limited. Manual reduction treatment of complex unstable distal radius fracture is easy to shift again, and the risk of malunion is higher. And the function recovery is poor.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.1

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