摘要
目的桡骨远端骨折切开复位内固定术后的最佳制动时间尚未确定,本研究为明确桡骨远端骨折术后制动2及4周对腕关节功能及疼痛的影响.方法自2020年10月至2021年10月选择60例桡骨远端骨折患者,采用掌侧钢板切开复位内固定术治疗,设计双盲、随机对照试验,将患者分为内固定术后制动2周组和4周组.外固定去除后进行为期6周的功能锻炼.主要疗效评价有PRWE评分评估腕关节功能,视觉模拟量表(visual analogue scale,VAS)评价疼痛程度,腕关节主动屈伸、尺偏、桡偏和前臂旋前、旋后活动范围,DASH评分,握力,恢复工作和日常活动时间.术后6、12、24周记录以上各项指标,并记录两组不良事件发生率.结果所有患者均接受了随机分配治疗,87%的参与者完成了6个月的随访.术后6周时,制动2周组的PRWE评分、腕关节屈伸和前臂旋后活动范围均明显优于固定4周组(P<0.05).术后12或24周时两组主要功能评价结果比较,差异无统计学意义(P>0.05).两组不良反应发生率差异无统计学意义(P>0.05).结论桡骨远端骨折掌侧钢板内固定术后制动2周,没有增加复位丢失发生率,可以获得更好的早期功能恢复.
Objective To determine the effect of immobilization for 2 and 4 weeks after operation of distal radius fracture on wrist function and pain because the best immobilization time after open reduction and internal fixation of distal radius fracture has not been determined.Methods From October 2020 to October 2021,60 patients with distal radius fractures were selected and treated with open reduction and internal fixation with volar plate.A double-blind,randomized controlled trial was designed.The patients were divided into two groups,one with 2-week immobilization afer internal fixation and one with 4-week immobilization.The functional exercise was performed for 6 weeks after removal of external fixation.The main efficacy evaluation included PRWE score to evaluate wrist function,visual analog scale(VAS)to evaluate the degree of pain,active range of motion of wrist flexion and extension,ulnar deviation,radial deviation,forearm pronation and supination,DASH score,grip strength,time to resume work and daily activities.The above indexes were recorded 6,12 and 24 weeks after operation,and the incidence of postoperative adverse events in the two groups was recorded.Results All the participants received randomly assigned treatment,and 87%completed 6-month follow-up.At 6 weeks after operation,the PRWE score,the range of motion of wrist flexion and extension and forearm supination in the 2-week immobilization group were significantly better than those in the 4-week immobilization group(P<0.05).At 12 or 24 weeks after operation,there was no significant difference between the two groups in the main function evaluation results(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The immobilization for 2 weeks after internal fixation with volar plate for distal radius fractures does not increase the incidence of reduction loss,and can achieve better early functional recovery.
作者
杜晓龙
欧学海
熊咏民
胡东
刘超
成德亮
段虹昊
郑前进
许玉本
Du Xiaolong;Ou Xuehai;Xiong Yongmin;Hu Dong;Liu Chao;Cheng Deliang;Duan Honghao;Zheng Qianjin;Xu Yuben(Department of Hand Surgery,Xi'an Honghui Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710054,China;Institute of Endemic Disease,School of Medicine,Xi'an Jiaotong University,Xi'an 710065,China)
出处
《中华手外科杂志》
CSCD
北大核心
2023年第3期244-247,共4页
Chinese Journal of Hand Surgery
关键词
桡骨骨折
治疗结果
内固定
康复
制动
Radiusfractures
Treatment outcome
Internal fixation
Rehabilitation
Immobilization
作者简介
通信作者:欧学海,Email:ouxuehai2007@126.com。
