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改良石膏外固定治疗老年人桡骨远端粉碎性骨折 被引量:6

Clinical analysis of modified plaster external fixation in the treatment of the senile comminuted fractures of distal radius in elderly patients
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摘要 目的探讨改良石膏固定技术在治疗老年桡骨远端粉碎性骨折的可行性及临床应用价值。方法回顾本院治疗的547例老年桡骨远端粉碎性骨折患者,按治疗方法不同分为手术组、传统石膏组及改良石膏组,平均随访50周。石膏固定期间的舒适度从腕关节疼痛程度(VAS评分)、肢体肿胀消失时间、并发症(包括掌侧皮肤压疮及急性腕管综合征)发生率及平均治疗费用四个方面评价。疗效和影像学改变采用PRWE评分、Stewart改良的Sanniento评分等进行评价。结果石膏固定期间,改良石膏外固定组在腕关节疼痛程度、肢体肿胀消失时间、并发症发生率及平均治疗费用四个方面均低于传统石膏固定组(t=13.834、12.709、29.443、12.900,均P〈0.05)。治疗后10周的腕关节功能在PRWE评分结果显示,手术组(12.87±3.23)分与改良石膏外固定组(13.01±3.67)分均比传统石膏固定组(18.76±5.49)分功能优越(t=12.985,P〈0.05),而手术组与改良石膏组的差异无统计学意义(t=0.830,P〉0.05)。在影像学评价方面,10周时的改良Sarmiento评分显示改良石膏固定组(2.62±2.83)分与传统石膏固定组(2.92±2.95)分之间的差异无统计学意义(t=0.544,P〉0.05),而手术治疗组(1.29±2.13)分的复位情况优于石膏治疗组(t=5.518,P〈0.05)。随访50周时,3组之间腕关节功能差异无统计学意义(F=1.826,P〉0.05)。结论改良石膏固定治疗老年C型桡骨远端粉碎性骨折比传统石膏固定治疗在石膏固定期间的舒适度、短期内腕关节功能恢复等方面有优势,并能减少并发症、降低患者负担,有一定的推广价值。 Objective To explore the feasibility and clinical value of the modified plaster external fixation in the treatment of the senile comminuted fractures of distal radius. Methods The 547 patients with the senile eomminuted fractures of distal radius were reviewed to clinically evaluate the modified plaster external fixation. The clinical value of 12-lead electrocardiogram after successful reperfusion therapy for acute myocardial infarction was evaluated. All patients were divided into operation group, traditional plaster external fixation group and modified plaster external fixation group. The mean follow up time was 50 weeks. The comfort degree of patients during therapy was appraised by the score of wrist pain, the time of swelling disappearance,complications rates of palmaris pressure sores and acute carpal tunnel syndrome, and the average treatment costs. The efficacy and radiographic changes were assessed by PRWE score and Sanniento score modified by Stewart. Results The grade of wrist pain, the time of swelling disappearance, complication rates and the average treatment cost were less in the modified plaster external fixation group than in traditional plaster external fixation group(t : 13. 834,12. 709,29. 443.12. 900, P〈0.05). PRWE score on wrist joint function after 10 weeks of treatment were better in the operation group(12.87±3.23) and modified plaster external fixation group(13, 01± 3.67)than in traditional plaster external fixation group ( 18. 76± 5.49) ( t = 12. 985, P〈 0. 05 ). The differenees in above parameters were not statistically significant between operation group and modified plaster external fixation group ( t = 0. 830, P 〉 0. 05 ). Based on radiologie evaluations, the improved Sarmiento score after 10 weeks of treatment was(2.62 ± 2. 83)in modified plaster external fixation group, (2.92 ± 2. 95 ) in traditional plaster external fixation group (t :0. 544,P〉0.05, between the two groups), and(1.29 ± 2.13) in operation group(vs, two plas
作者 曾荣东 张钰 孙炜俊 林金丁 黄杰聪 陈巧凤 汤海峰 施建辉 Zeng Rongdong , Zhang Yu , Sun Weijun , Lin Jinding , Huang Jiecong , Chen Qiaofeng , Tang Hai feng , Shi Jianhui (Department of Orthopedics Quanzhou First Hospital Affiliated of Fujian Medical University, Quanzhou 362000, China)
出处 《中华老年医学杂志》 CAS CSCD 北大核心 2016年第10期1107-1110,共4页 Chinese Journal of Geriatrics
关键词 石膏 外科 桡骨骨折 骨折 粉碎性 plaster surgery radius fracture comminuted fractures
作者简介 通信作者:曾荣东,Email:zrdng@126.com
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