手法復(fù)位石膏托固定治療Colles骨折的效果觀察

白俊龍

【摘要】 目的：探討手法復(fù)位石膏托固定治療Colles骨折的臨床效果。方法：匯總筆者所在醫(yī)院2015年8月-2016年8月手法復(fù)位石膏托固定治療的Colles骨折患者共115例，分析統(tǒng)計(jì)手法復(fù)位前、后X線片中掌傾角、尺偏角及橈骨長(zhǎng)度的變化情況，隨訪并收集腕關(guān)節(jié)功能評(píng)定結(jié)果。結(jié)果：115例患者中共有男26例，女89例，復(fù)位前掌傾角均值-18.7°，復(fù)位后掌傾角均值7.2°；復(fù)位前尺偏角均值12.6°，復(fù)位后尺偏角均值17.5°，橈骨長(zhǎng)度恢復(fù)均值0.3 cm。所有患者的骨折對(duì)位情況均得到改善，所有患者全部骨性愈合。隨訪1年，腕關(guān)節(jié)功能優(yōu)90例，良20例，差5例。結(jié)論：手法復(fù)位石膏托固定治療Colles骨折是一種有效、可靠的治療方法，有較高的臨床應(yīng)用價(jià)值。

【關(guān)鍵詞】 Colles骨折； 手法復(fù)位； 石膏托固定

doi：10.14033/j.cnki.cfmr.2017.29.008 文獻(xiàn)標(biāo)識(shí)碼 B 文章編號(hào) 1674-6805（2017）29-0016-02

Clinical Effects of Manual Reduction with Plaster External Fixation in the Treatment of Colles Fracture Patients/BAI Jun-long.//Chinese and Foreign Medical Research，2017，15（29）：16-17

【Abstract】 Objective：To observe clinical effects of manual reduction with plaster external fixation in the treatment of Colles fracture patients.Method：From August 2015 to August 2016，115 patients with Colles fractures treated with manual reduction and plaster fixation were observed.We analyzed the data of the angle of radial inclination，ulnar inclination and length of distal radius on the X-ray before manual reduction and after manual reduction.The wrist joint function was followed-up and assessed.Result：The 115 patients had 26 males and 89 females.The mean angle of the radial inclination before manual reduction was -18.7°，the ulnar inclination was 12.6°.The mean angle of the radial inclination after manual reduction was 7.2°，the ulnar inclination was 17.5°.The length of distal radius was corrected of about 0.3 cm.All patients got bony union and both angles on X-ray got improved.The patients were followed up 1 year，the wrist function results were as follows，90 excellent cases，20 good cases and 5 poor ones.Conclusion：The method of the manual reduction with plaster external fixation in the treatment of Colles fracture patients is effective and reliable and it has good clinical application value.

【Key words】 Colles fracture； Manual reduction； Plaster external fixation

First-authors address：Civil Aviation General Hospital，Beijing 100123，China

橈骨遠(yuǎn)端骨折被定義為距橈骨遠(yuǎn)端關(guān)節(jié)面3 cm以內(nèi)的骨折，骨折的同時(shí)常伴有腕關(guān)節(jié)及下尺橈關(guān)節(jié)的損傷。Colles骨折是橈骨遠(yuǎn)端骨折中的一種特定類型，1814年由Abraham Colles給予了比較系統(tǒng)的描述，此后大家便把橈骨遠(yuǎn)端骨折后骨折遠(yuǎn)端向背側(cè)及橈側(cè)移位、橈骨發(fā)生短縮的特定骨折類型稱為Colles骨折。骨折最常見的原因是跌倒后的間接暴力（肘部伸直、前臂旋前、腕關(guān)節(jié)背伸、手掌著地），尤其冬天雪后地滑，更容易不慎滑倒。Colles骨折的治療可分為兩類，即閉合治療和開放治療。閉合治療包括手法復(fù)位石膏托固定治療、閉合穿克氏針治療、外固定架治療及聯(lián)合治療；開放治療則為切開復(fù)位接骨板手術(shù)治療，接骨板可選擇放置于掌側(cè)亦可以放置于背側(cè)，應(yīng)個(gè)體化操作。……