桡骨远端骨折小夹板固定后轴向移位的观察△

Axial displacement of distal radius fractures after external fixation with traditional Chinese splint

摘要:

[目的]探讨桡骨远端骨折小夹板固定后轴向移位对腕关节功能的影响。[方法]2019 年 1 月—2019 年 10 月手法复位小夹板固定后桡骨轴向移位患者 45 例，依据复位后 3 个月末次随访时桡骨远端轴向移位程度分为＜2.5 mm 组 24 例，≥2.5 mm 组 21 例。采用 Mayo 评分评价腕关节功能。测量两组末次随访时 X 线片桡骨短缩移位程度、掌倾角及尺偏角。[结果]3 个月以上的末次随访时两组间 Mayo 评分的两组疼痛评分差异无统计学意义(P＞0.05)，但是＜2.5 mm 组在功能、握力、活动范围及 Mayo 总分方面均显著优于≥2.5 mm 组，差异均有统计学意义(P＜0.05)。末次随访时＜2.5 mm 组的轴向移位、掌倾角、尺偏角均显著优于≥2.5 mm 组(P＜0.05)。[结论]桡骨远端骨折小夹板固定后存在桡骨轴向移位现象，其轴向移位＜2.5 mm 对腕关节功能影响较小。

Abstract:

[Objective] To investigate the effect of axial displacement on clinical outcomes of distal radius fractures fixed with tradition- al Chinese splints. [Methods] From January 2019 to October 2019, 45 patients received manual reduction and external fixation with tradi- tional Chinese splint for distal radial fractures. Based on the radial axial displacement at the latest follow up, 24 patients fall into the ＜ 2.5mm group, while 21 patients were in the ≥ 2.5 mm group. Wrist function was assessed by using Mayo score, additionally, the extent of ra- dius shortening displacement, palmar tilt and radial angle on radiographs were measured and compared between the two groups at the last follow-up. [Results] At the last follow-up of more than 3 months, there was no significant difference in the Mayo pain subscore between the two groups (P＞0.05) , but the ＜2.5 mm group was significantly superior to the ≥2.5 mm group in terms of function, grip strength, range of motion subscores and the total Mayo score, with statistical significances (P＜0.05) . At the last follow-up, the ＜2.5 mm group proved signifi- cantly superior to the ≥2.5 mm group in terms of axial displacement, palmar tilt and radial angle (P＜0.05) . [Conclusion] Axial displace- ment of the distal radius occurred after traditional splint fixation, however, the axial displacement ＜2.5 mm has little effect on wrist joint function.