| 带沟槽夹板固定桡骨远端骨折对患肢肿胀和血流速度的影响 |
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投稿时间：2023-08-29 修订日期：2024-02-20
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| 期刊信息：《中国骨伤》年，第卷，第期，第-页 |
| DOI： |
| 基金项目:重庆市九龙坡区科技局基础研究与成果转化类科技计划项目(编号：2021-02-008-Y)；重庆市中医药重点学科建设项目(渝中医〔2019〕11号)；重庆市科卫联合中医药科技项目(编号：ZY201802002)。 |
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| 中文摘要:目的：观察带沟槽夹板固定桡骨远端骨折对患肢手部肿胀及血流速度的影响。方法：选取2021 年 3月至2022年2月单侧闭合性桡骨远端骨折64例,均采取手法复位小夹板外固定。随机数字表分为沟槽夹板组、常规夹板组,每组各32例,记录两者年龄、性别、受伤侧别、AO分型、受伤时间等资料,测量两组病例术后第1、3、7、14天双上肢手背周径,肿胀值为患肢和健侧周径差,第1、3、7天双上肢掌浅弓、掌背静脉血流速度值,复位前和术后3月 X线片的桡骨茎突高度、掌倾角、尺偏角,以及术后3月DASH评分,并进行统计学分析。结果：两组病例一般资料比较,差异均无统计学意义(P>0.05),具有可比性。沟槽夹板组掌部肿胀值在第3、7、14天时,较常规夹板组改善明显,差异有统计学意义(F3d=7.650,F7d=12.089,F14d=6.858,P<0.001)；夹板固定后第1天,沟槽夹板组掌浅弓血流速度差低于常规夹板组,差异具有统计学意义(F1d =2.335,P<0.05),第3、7天时,差异无统计学意义(F3d=2.273,F7d=1.643,P>0.05)；掌背静脉血流速度差值比较,夹板固定后第1天,两组差异无统计学意义(F1d=1.894,P>0.05),第3、7天沟槽夹板组血流速度差值较常规夹板组减少,差异具有统计学意义(F3d =3.641,F7d =3.472,P<0.05)。复位前后桡骨远端掌倾角、尺偏角、桡骨高度差异均无统计学意义(P>0.05)；3月随访时DASH评分差异有统计学意义(F=2.505,P<0.05)。 结论：带沟槽夹板固定桡骨远端骨折,可以降低对掌浅弓和掌背静脉血流速度的影响,减少静脉回流障碍,改善患肢掌背肿胀程度,减轻腕指关节僵硬,提高患肢早期临床疗效。 |
| 【关键词】夹板 桡骨远端骨折 保守治疗 血流速度 肿胀 |
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| The Effect of Groove Splint Fixation on Limb Swelling and Blood Flow Velocity in Distal Radius Fractures1.Department of Orthopedics, Jiulongpo Hospital of Traditional Chinese Medicine, 400080, Chongqing, China. |
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| ABSTRACT ABSTRACT Objective: To observe the effect of groove splint fixation on the swelling and blood flow velocity of the affected limb's hand in distal radius fractures. Methods: A Case–control study was conducted to select 64 cases of unilateral closed distal radius fractures from March 2021 to February 2022. All cases were treated with manual reduction and external fixation with small splints. Randomly divide the number table into two groups, 32 cases in the groove splint group and 32 cases in the conventional splint group. Record the age, gender, injury side, AO classification, injury time, and other data of both groups. Record the swelling values of both upper limbs on 1, 3, 7 and 14 days after surgery (difference in circumference between the affected and healthy sides), the blood flow velocity values of the superficial palmar arch and dorsal palmar vein of both upper limbs on 1, 3, and 7 days, as well as the height of the radial styloid process, palm inclination angle, and ulnar deviation angle on X-ray films before reduction and three months after surgery, And DASH score at 3 months after surgery, and statistical analysis was conducted. Result: The general data of the two groups of cases were compared, and the difference was not statistically significant (P>0.05), indicating comparability. The swelling value of the palm in the groove splint group was significantly improved compared to the conventional splint group on days 3, 7, and 14, with a statistically significant difference (F3d=7.650，F7d=12.089，F14d=6.858，P<0.001); On the first day after splint fixation, the difference in blood flow velocity of the superficial palmar arch in the groove splint group was lower than that in the conventional splint group, with statistical significance (F1d =2.335，P<0.05). On the 3rd and 7th days, the difference was not statistically significant (F3d=2.273，F7d=1.643，P>0.05); Comparison of blood flow velocity differences between the dorsal metacarpal vein and the two groups showed no statistically significant difference on the first day after splint fixation (F1d=1.894，P>0.05). On the 3rd and 7th days, the blood flow velocity difference between the groove splint group decreased compared to the conventional splint group, and the difference was statistically significant (F3d =3.641，F7d =3.472，P<0.05). There was no statistically significant difference in the palm angle, ulnar deviation angle, and radius height of the distal radius before and after reduction (P>0.05); There was a statistically significant difference in DASH scores during the 3-month follow-up (F=2.505，P<0.05). Conclusion: Fixing distal radius fractures with groove limited contact pressure splints can reduce the early impact on the blood flow velocity of the superficial palmar arch and dorsal palmar vein, reduce venous reflux obstruction, reduce swelling of dorsal palmar and improve clinical efficacy. |
| KEY WORDS Splint Distal radius fracture Conservative treatment Blood velocity swelling |
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