中国组织工程研究

中国组织工程研究 ›› 2018, Vol. 22 ›› Issue (27): 4294-4299.doi: 10.3969/j.issn.2095-4344.0342

• 骨科植入物 orthopedic implant • 上一篇    下一篇

桡骨远端骨折新型夹板的临床验证及改良设计

颜 威1，2，3，孔 博1，2，3，蒋 涛1，2，3，贾友冀1，奚小冰1，2，3   

  1. 1上海交通大学医学院附属瑞金医院，上海市 200025；2上海市中西医结合防治骨与关节病损重点实验室，上海市 200025；3上海市伤骨科研究所，上海市 200025
  • 出版日期:2018-09-28 发布日期:2018-09-28
  • 通讯作者: 奚小冰，主任医师，上海交通大学医学院附属瑞金医院伤科，上海市 200025
  • 作者简介:颜威，男，1992年生，江苏省人，汉族，上海交通大学医学院在读硕士，主要从事骨与关节损伤的外固定研究。
  • 基金资助:

    上海市中医药发展办公室海派中医流派魏氏伤科传承研究基地建设项目(ZY3-CCCX-1-1014)；上海交通大学医工交叉研究基金重点项目(YG2015ZD02)；上海市卫生和计划生育委员会科研重点课题(201640021)；上海市卫计委中医药科研专项课题项目(2016LQ021)；李飞跃全国名老中医药专家传承工作室(MLZJGZS-2017001)；上海市名老中医李飞跃学术经验研究工作室(SHGZS-2017010)

Clinical verification and improved design of the new traction splint for distal radius fractures

Yan Wei1, 2, 3, Kong Bo1, 2, 3, Jiang Tao1, 2, 3, Jia You-ji1, Xi Xiao-bing1, 2, 3   

  1. 1Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 2Shanghai Key Laboratory of Prevention and Treatment of Bone and Joint Diseases, Shanghai 200025, China; 3Shanghai Institute of Traumatology and Orthopedics, Shanghai 200025, China
  • Online:2018-09-28 Published:2018-09-28
  • Contact: Xi Xiao-bing, Chief physician, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Shanghai Key Laboratory of Prevention and Treatment of Bone and Joint Diseases, Shanghai 200025, China
  • About author:Yan Wei, Master candidate, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Shanghai Key Laboratory of Prevention and Treatment of Bone and Joint Diseases, Shanghai 200025, China
  • Supported by:

    the Shanghai Development Office of Traditional Chinese Medicine, WEISHI Department of Traumatology, Heritage Research Base Construction Project, No. ZY3-CCCX-1-1014; the Key Project of the Medical-Engineering Cross Research Foundation of Shanghai Jiao Tong University, No. YG2015ZD02; the Key Scientific Research Project of Shanghai Municipal Commission of Health and Family Planning, No. 201640021; the Research Project of Chinese Medicine of Shanghai Municipal Commission of Health and Family Planning, No. 2016LQ021; Li feiyue National Famous TCM Expert Inheritance Studio ,No. MLZJGZS-2017001; the Shanghai Famous Old Chinese Medicine Doctor Li feiyue Academic Experience Research Studio, No. SHGZS-2017010.

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摘要：

文章快速阅读：


文题释义：
新型牵引型夹板：是依据传统小夹板的“弹性固定”理论以及促进骨折愈合的“微动”理论设计研发的一款新型夹板，在夹板的背侧板和掌侧板各加入齿轮状的牵引结构，通过不断牵拉夹板，起到对骨折断端拔伸牵引得作用，促进骨折的愈合。
新型牵引型夹板的优势：其中牵引功能模块的设计更是其亮点所在，通过不断地微牵引，既加快了骨折的愈合又减轻了局部的肿胀不适。此外它还具有以下特点：①可调性：可根据患肢的肿胀程度实时调节外固定带的松紧程度，避免了压疮以及骨筋膜室综合征的出现；②透光性：新型牵引型夹板具有良好的X射线透光性，与石膏相比可以清晰的观察骨折愈合的情况；③舒适性：新型牵引型夹板具有透气，柔软舒适的特点。
 
摘要
背景：新型牵引型夹板是依据传统小夹板的“弹性固定”理论以及促进骨折愈合的“微动”理论设计研发的一款新型夹板，治疗桡骨远端骨折具有广阔的应用价值与应用前景。
目的：通过对新型牵引型夹板进行临床验证来探讨其性能，并对其不足进行改良设计。
方法：将40例桡骨远端骨折患者按照就诊时间顺序随机分为新型牵引型夹板组和石膏管型组，每组20例。分别在复位固定后即刻、固定2周、固定6周摄腕关节正侧位X射线片，根据X射线片对2组固定6周的骨折愈合情况进行对比；运用PACS系统分析测量固定后即刻、固定6周的桡骨高、掌倾角以及尺偏角；同时比较2组固定0，3，7，14 d的疼痛、肿胀程度，并按照Gartland和Werley(G-W)腕关节评分系统对腕关节功能进行评价。
结果与结论：①新型牵引型夹板组在骨折愈合速度及减轻患肢的肿胀程度方面均显著优于石膏管型组，差异有显著性意义(P < 0.05)；②在骨折固定6周，新型牵引型夹板组的临床疗效要优于石膏管型组(P < 0.05)；骨折3个月后，2组临床疗效差异无显著性意义；③在复位后、固定6周桡骨高、掌倾角以及尺偏角方面新型牵引型夹板组与石膏管型组相比差异无显著性意义(P > 0.05)，在复位后与固定6周掌倾角变化值方面，石膏管型组要稍优于新型牵引型夹板组；④此外新型牵引型夹板与石膏管型治疗都存在不同程度的并发症，但在较严重并发症方面新型牵引型夹板发生率要少于传统石膏管型固定治疗；⑤提示新型牵引型夹板治疗桡骨远端骨折具有明显的优势和确切疗效，但也存在许多不足，需要在轻量化、外形、牵引结构以及内衬等方面不断地进行改良设计。

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程
ORCID: 0000-0002-4353-7970(颜威)

关键词: 桡骨远端骨折, 牵引型, 夹板, 临床研究, 改良设计

Abstract:

BACKGROUND: New traction splint is developed base on “elastic fixation” theory of traditional splint and “minimal movement” theory of promoting fracture healing, which exhibits broad application values and prospects in the treatment of distal radius fractures.

OBJECTIVE: To explore the performance of the new traction splint by clinical research, and to improve its deficiencies.
METHODS: Forty patients with distal radius fractures were randomly divided into trial (new traction splint) and control (plaster fixation) groups (n=20 per group). The X-ray films of the wrist joint were performed immediately, 2 and 6 weeks postoperatively to compare the fracture healing. PACS system was used to measure the height of radius, palm inclination and ulnar deviation immediately and 6 weeks postoperatively. The pain and swelling degree at 0, 3, 7 and 14 days were compared. The wrist function was assessed according to Gartland and Werley evaluation system.
RESULTS AND CONCLUSION: (1) The speed of fracture healing and swelling relief in the trial group were significantly better than those in the control group (P < 0.05). (2) The curative efficacy at postoperative 6 weeks in the trial group was significantly superior to that in the control group (P < 0.05), and the curative efficacy showed no significantly between two groups at postoperative 3 months. (3) There was no significant difference in the height of radius, palm inclination and ulnar deviation after reduction and 6 weeks after fixation between two groups (P > 0.05). The change value of palm inclination in the control group was slightly superior to that in the trial group. (4) Different degrees of complications occurred in both groups, but the incidence of severe complications in the trial group was lower than that in the control group. (5) Our findings indicate that the new traction splint has obvious advantages and definite curative effect in the treatment of distal radius fracture, but there are many shortcomings. It needs to be improved in the aspects of light weight, shape, traction structure and inner lining.

Key words: Radius Fractures, External Fixators, Tissue Engineering

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