中国骨伤
中國骨傷
중국골상
CHINA JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY
2014年
6期
478-481
,共4页
桡骨骨折%手法,整骨%小夹板固定%生物力学
橈骨骨摺%手法,整骨%小夾闆固定%生物力學
뇨골골절%수법,정골%소협판고정%생물역학
Radius fractures%Manipulation,osteopathic%Small splint fixation%Biomechanics
目的:探讨“三柱理论”在Colles骨折手法复位、小夹板固定及早期功能锻炼中的指导作用,并通过生物力学原理进行定性分析。方法:自2011年8月至2012年2月,在桡骨远端“三柱理论”指导下,采用手法复位、小夹板固定及早期指导功能锻炼治疗47例Colles骨折患者,其中男21例,女26例;年龄40~76岁,平均(65.5±2.3)岁。桡骨远端骨折AO分型:A型27例,其中A2型18例,A3型9例;C型20例,其中C1型10例,C2型6例,C3型4例。术后观察记录疼痛和肿胀恢复时间及术后并发症情况,术后12周采用Gartland-Werley评分系统对腕关节功能进行系统评价,并进行生物力学定性分析。结果:47例患者均获随访,时间3~9个月,平均5个月。术后自觉疼痛缓解时间5~15 d,平均(7.6±2.2) d;手背肿胀消退时间6~13 d,平均(8.9±1.9) d,在治疗过程中有2例患者3 d内出现张力性水泡,无其他并发症发生。术后12周Gartland-Werley评分,优25例,良18例,中4例。结论:Colles骨折在桡骨远端“三柱理论”指导下进行手法复位、小夹板固定及早期功能锻炼,可减缓疼痛和肿胀时间,促进骨折愈合,有效恢复腕关节功能,临床疗效确切,具有合理的生物力学理念。
目的:探討“三柱理論”在Colles骨摺手法複位、小夾闆固定及早期功能鍛煉中的指導作用,併通過生物力學原理進行定性分析。方法:自2011年8月至2012年2月,在橈骨遠耑“三柱理論”指導下,採用手法複位、小夾闆固定及早期指導功能鍛煉治療47例Colles骨摺患者,其中男21例,女26例;年齡40~76歲,平均(65.5±2.3)歲。橈骨遠耑骨摺AO分型:A型27例,其中A2型18例,A3型9例;C型20例,其中C1型10例,C2型6例,C3型4例。術後觀察記錄疼痛和腫脹恢複時間及術後併髮癥情況,術後12週採用Gartland-Werley評分繫統對腕關節功能進行繫統評價,併進行生物力學定性分析。結果:47例患者均穫隨訪,時間3~9箇月,平均5箇月。術後自覺疼痛緩解時間5~15 d,平均(7.6±2.2) d;手揹腫脹消退時間6~13 d,平均(8.9±1.9) d,在治療過程中有2例患者3 d內齣現張力性水泡,無其他併髮癥髮生。術後12週Gartland-Werley評分,優25例,良18例,中4例。結論:Colles骨摺在橈骨遠耑“三柱理論”指導下進行手法複位、小夾闆固定及早期功能鍛煉,可減緩疼痛和腫脹時間,促進骨摺愈閤,有效恢複腕關節功能,臨床療效確切,具有閤理的生物力學理唸。
목적:탐토“삼주이론”재Colles골절수법복위、소협판고정급조기공능단련중적지도작용,병통과생물역학원리진행정성분석。방법:자2011년8월지2012년2월,재뇨골원단“삼주이론”지도하,채용수법복위、소협판고정급조기지도공능단련치료47례Colles골절환자,기중남21례,녀26례;년령40~76세,평균(65.5±2.3)세。뇨골원단골절AO분형:A형27례,기중A2형18례,A3형9례;C형20례,기중C1형10례,C2형6례,C3형4례。술후관찰기록동통화종창회복시간급술후병발증정황,술후12주채용Gartland-Werley평분계통대완관절공능진행계통평개,병진행생물역학정성분석。결과:47례환자균획수방,시간3~9개월,평균5개월。술후자각동통완해시간5~15 d,평균(7.6±2.2) d;수배종창소퇴시간6~13 d,평균(8.9±1.9) d,재치료과정중유2례환자3 d내출현장력성수포,무기타병발증발생。술후12주Gartland-Werley평분,우25례,량18례,중4례。결론:Colles골절재뇨골원단“삼주이론”지도하진행수법복위、소협판고정급조기공능단련,가감완동통화종창시간,촉진골절유합,유효회복완관절공능,림상료효학절,구유합리적생물역학이념。
Objective:To explore guiding role of three column theory in manipulative reduction ,small splint fixation and early rehabilitative exercises of Colles fracture. Methods:From August 2011 to February 2012,47 patients with Colles frac-tures were treated by manipulative reduction small splinting fixation and early rehabilitative exercises under the guidance of three column theory,including 21 males and 26 females aged from 40 to 76 years old with an average of (65.5±2.3). According to AO fracture classification,27 patients were type A (including 18 cases with type A2 and 9 cases with type A3) and 20 pa-tients were type C (including 10 cases with type C1,6 cases with type C2 and 4 cases with type C3). Pain and recovery time of swelling,postoperative complications were observed and recorded,Gartland-Werley scoring system were applied for evaluate functional recovery and biomechanical analysis of wrist joint at 12 weeks after operation. Results:All patients were followed up for 3 to 9 months with average of 5 months. Pain relief time ranged from 5 to 15 d with average of (7.6 ± 2.2) d,recovery time of swelling of opisthenar was for 6 to 13 d with an average of (8.9 ± 1.9) d. Two patients occurred tension vesicle within 3 days after operation,but no other complications occurred. According to Gartland-Werley scoring system ,25 cases got excellent re-sults,18 cases good and 4 cases moderate at 12 weeks after operation. Conclusion:Under the guidance of three-column theo-ry,treating Colles fracture by manipulative reduction,small splinting fixation and early rehabilitative exercises can reduce pain and swelling time,promote union of fracture,effectively rehabilitate wrist function,improve clinical efficacy,and fit for concept of biomechanics .