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

doi:10.3969/j.issn.2095-4344.0342

Abstract

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

CLC Number:

R318

Yan Wei, Kong Bo, Jiang Tao, Jia You-ji1, Xi Xiao-bing . Clinical verification and improved design of the new traction splint for distal radius fractures[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(27): 4294-4299.

Figures/Tables 2

2.4 疼痛与肿胀结果比较 2组骨折当天的疼痛、肿胀比较差异无显著性意义(P > 0.05)，说明2组之间基线一致具有可比性。在固定3，7，14 d疼痛方面，2组差异无显著性意义(P > 0.05)；在3，7 d肿胀程度方面，新型牵引型夹板固定组要优于石膏管型固定组(P < 0.05)，但14 d时2组肿胀程度差异无显著性意义(P > 0.05)，见表4。 2.5 影像学结果比较 2组骨折复位前、后桡骨高、掌倾角及尺偏角比较差异无显著性意义(P > 0.05)，具有可比性。新型牵引型夹板组复位外固定6周后在尺偏角、掌倾角、桡骨高方面与石膏管型组比较差异亦无显著性意义；新型牵引型夹板组患者外固定6周后的掌倾角变化值略大于石膏管型组，2组之间差异有显著性意义(P < 0.05)，说明2种外固定方式均能较好地维持骨折断端复位后位置，对于复位后掌倾角的维持，石膏管型要优于新型牵引型夹板，见表5-7。 2.6 临床疗效比较骨折固定6周，患侧腕关节G-W评分新型牵引型夹板组要优于石膏管型组(Z=-2.660，P=0.008 < 0.05)；骨折3个月后，2组患侧腕关节G-W评分差异无显著性意义(Z=-0.652，P=0.514 > 0.05)，见表8。 2.7 并发症比较在治疗期间，新型牵引型夹板组未出现皮肤压迫性溃疡或骨筋膜室综合征等不良并发症；而石膏管型组出现2例皮肤压迫性溃疡，溃疡处石膏予以切除处理，待其自然愈合，未见明显皮肤不适。治疗6周后，新型牵引型夹板组1例患者出现患肢腕部晨起肿胀现象，4例出现拇指活动稍僵硬(与健侧比)，嘱其拇指旋转活动并与其他4指不断进行对指练习，6周后拇指活动基本正常；石膏管型组6例出现患肢腕部晨起肿胀现象，对于晨起肿胀的患者，嘱其加强腕部的功能锻炼以及温水泡手，促进血液循环，减轻肿胀[15]，但6周后仍稍有肿胀。新型牵引型夹板不良并发症少于石膏管型组，说明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的发生率少于传统石膏管型固定治疗。"

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