特制牵引夹板与石膏固定治疗移位型桡骨远端骨折随机对照研究

doi:10.13418/j.issn.1001-165x.2023.4.19

Abstract

Abstract: Objective To investigate the effect of special traction splint vs plaster immobolization in the treatment of distal radius fractures and clarify the mechanism of traction splint. Methods Total of 70 patients with displaced distal radius fractures treated conservatively were randomly divided into an experimental group ( traction splint immobolization, 35 cases) and a control group (plaster immobolization , 35 cases). There was no significant difference in age, gender, fracture type and fixation timing, and visual analog scale (VAS) for pain between the two groups (P>0.05). The fracture healing and fixation time, re-displacement, unacceptable displacement, operation rate, radius height, radial inclination angle, palmar inclination, range of motion (ROM) of radial-ulnar inclination，flection- extension and rotation, VAS for pain, hand grip strength, patient-rated wrist evaluation (PRWE) and wrist functional recovery (Gartland- Werley’s method) were compared between the two groups. Results The re-displacement, unacceptable displacement and operation rate of the experimental group were less than those of the control group, and the differences were statistically significant (P<0.05). There was no significant difference in fracture healing time and fixation time between the two groups (P>0.05). All the patients were followed-up for 10 to 18 months, with an average follow-up of 12.2 months. At the last follow-up, the radius height and radius inclination angle of the experimental group were better than those of the control group, and the differences were statistically significant (P<0.05). However, there was no significant difference in the palmar inclination, ROMs of radius-ulnar inclination, flection-extension and rotation, VAS, hand grip strength, patient-rated wrist evaluation (PRWE), and excellent to good rate of wrist function between the two groups (P>0.05). Conclusions Comparing with plaster, traction splint immobolization can better maintain the position of distal radius fracture and the height of radius, reduce the re-displacement and operation rate, and the overall effect is better.

Key words: Distal radius fracture; , , Splint; , , Plaster; , , Traction splint; , , Longitudinal traction

CLC Number:

R683.41

Li Xin, Yin Qudong, Wei Xuming, Yang Haoxia, Lu Yao, Liu Jun, Rui Yongjun . A randomized controlled study of special traction splint vs cast immobilization in the treatment of displaced distal radius fractures[J]. Chinese Journal of Clinical Anatomy, 2023, 41(4): 481-486.

References 21

[1]	丁玲, 唐文, 高慧秋, 等. 两类桡骨远端die-punch骨折的影像学比较[J]. 中国临床解剖学杂志, 2020, 38(1): 83-87. DOI: 10.13418/j.issn.1001-165x.2020.01.017.
[2]	赵景新, 马雅昌, 朱雅文, 等. 3D打印用于青少年Salter-HarrisⅡ型桡骨远端骨折辅助治疗的临床效果分析[J]. 中国临床解剖学杂志, 2018, 36(3): 346-348, 351. DOI: 10.13418/j.issn.1001-165x.2018.03.023.
[3]	欧梁, 卢敏, 张永辉, 等. 手法复位小夹板固定治疗老年桡骨远端骨折临床疗效Meta分析[J]. 中国中西医结合杂志, 2019, 39(1): 57-62. DOI: 10.7661/j.cjim.20171001.316.
[4]	蔡效信. 手术与非手术治疗桡骨远端骨折对患者腕关节功能恢复的影响[J]. 湖南中医药大学学报, 2016, 36(9): 72-74. DOI: 10.3969/j.issn.1674-070X.2016.09.019.
[5]	李绍良, 高志强, 鲁谊, 等. 保守治疗60岁以上桡骨远端骨折的可行性研究[J]. 中华创伤骨科杂志, 2012, 14(9): 763-766. DOI: 10.3760/cma.j.issn.1671-7600.2012.09.007.
[6]	Arora R, Lutz M, Deml C, et al. A prospective randomized trial comparing nonoperative treatment with volar locking plate fixation for displaced and unstable distal radial fractures in patients sixty-five years of age and older[J]. J Bone Joint Surg Am, 2011, 93(23): 2146-2153. DOI: 10.2106/JBJS.J.01597.
[7]	Hassellund S, Zolic-Karlsson Z, Williksen JH, et al. Surgical treatment is not cost-effective compared to nonoperative treatment for displaced distal radius fractures in patients 65 years and over[J]. Bone Jt Open, 2021, 2(12): 1027-1034. DOI: 10.1302/2633-1462.212.BJO-2021-0108.R1.
[8]	Hassellund SS, Williksen JH, Laane MM, et al. Cast immobilization is non-inferior to volar locking plates in relation to QuickDASH after one year in patients aged 65 years and older: a randomized controlled trial of displaced distal radius fractures[J]. Bone Joint J, 2021, 103-B(2): 247-255. DOI: 10.1302/0301-620X.103B2.BJJ-2020-0192.R2.
[9]	史秀罡, 郑春伟, 陆羽羽. 石氏伤科小夹板外固定加平衡牵引防治桡骨远端骨折短缩移位临床研究[J]. 河南中医, 2020, 40(10): 1573-1576. DOI: 10.16367/j.issn.1003-5028.2020.10.0399.
[10]	王海洲, 冯恩辉, 陈平. 手法整复小夹板外固定配合悬吊牵引治疗桡骨远端骨折临床研究[J]. 新中医, 2015, 47(1): 116-118. DOI: 10.13457/j.cnki.jncm.2015.01.056.
[11]	冯恩辉, 魏力, 王海洲, 等. 持续牵引器预防干骺端粉碎桡骨远端骨折复位丢失临床研究[J]. 新中医, 2016, 48(10): 112-114. DOI: 10.13457/j.cnki.jncm.2016.10.047.
[12]	杨玉元, 杨静, 张宏刚, 等. 自制偏心牵引带在桡骨远端骨折中的临床应用[J]. 中国骨伤, 2013, 26(8): 693-695. DOI: 10.3969/j.issn.1003-0034.2013.08.018.
[13]	唐珍岁. 手法整复小夹板外固定配合悬吊牵引治疗桡骨远端骨折的临床观察[J]. 中医临床研究, 2013, 5(3): 101-102. DOI: 10.3969/j.issn.1674-7860.2013.03.062.
[14]	颜威, 孔博, 蒋涛, 等. 桡骨远端骨折新型夹板的临床验证及改良设计[J]. 中国组织工程研究, 2018, 22(27): 4294-4299. DOI: 10.3969/j.issn.2095-4344.0342.
[15]	米萌, 李庭, 高志强. 桡骨远端骨折的规范化无痛闭合整复与石膏固定[J]. 骨科临床与研究杂志, 2019, 4(2): 123-128. DOI: 10.19548/j.2096-269x.2019.02.015.
[16]	Selles CA, Mulders MAM, Winkelhagen J, et al. Volar plate fixation versus cast immobilization in acceptably reduced intra-articular distal radial fractures: a randomized controlled trial[J]. J Bone Joint Surg Am, 2021, 103(21): 1963-1969. DOI: 10.2106/JBJS.20.01344.
[17]	Gartland JJ Jr, Werley CW. Evaluation of healed Colles' fractures[J]. J Bone Joint Surg Am, 1951, 33A(4): 895-907. PMID: 14880544.
[18]	肖鸿鹄, 李庭, 米萌, 等. 加速康复外科在创伤骨科无痛闭合整复桡骨远端骨折的前瞻性队列研究[J]. 中华创伤骨科杂志, 2019, 21(11): 945-951. DOI: 10.3760/cma.j.issn.1671-7600.2019.11.004.
[19]	Zhang P, Jia B, Chen XK, et al. Effects of surgical and nonoperative treatment on wrist function of patients with distal radius fracture[J]. Chin J Traumatol, 2018,21(1):30-33. DOI: 10.1016/j.cjtee. 2017. 11. 004.
[20]	郑上团, 吴斗, 郝海虎, 等. 桡骨远端骨折的治疗进展[J]. 中华骨科杂志,2016, 36(5): 314-320. DOI: 10.3760/cma.j.issn.0253-2352. 2016. 05. 009.
[21]	王簕, 杨云峰, James F Kellam. 老年人桡骨远端骨折手术治疗与非手术治疗的比较[J]. 中华创伤骨科杂志, 2011, 13(6): 579-588. DOI: 10.3760/cma.j.issn.1671-7600.2011.06.019.

A randomized controlled study of special traction splint vs cast immobilization in the treatment of displaced distal radius fractures

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