新型防旋支具在中西医结合保守治疗胫腓骨骨折中的应用

Application of new type of anti-rotation orthosis in the conservative treatment of tibiofibular fracture with integrated traditional Chinese medicine and Western medicine

关键词:  胫腓骨骨折  中西医结合  新型防旋支具

Key words:  tibiofibular fracture  integrated TCM-WM  new type of anti-rotation orthosis

摘要:

[目的]探讨新型防旋支具在中西医结合保守治疗胫腓骨骨折中的临床应用效果。[方法]2015年9月—2017年1月行保守治疗的胫腓骨骨折患者64例，随机分为试验组（32例）和对照组（32例）。两组患者入院后均行跟骨牵引术，中医正骨手法复位联合小夹板固定，辅以中药外敷内服。试验组术后采用新型防旋支具固定患肢，防止足部外旋；对照组术后采用传统的方法防止足部外旋。定期进行疼痛视觉模拟评分法（VAS法）评分，应用Kolcaba舒适状况量表（GCQ）检测舒适度改善状况，计算机断层扫描（CT）检查测量骨折旋转移位角度，随访记录骨折愈合时间及并发症情况，采用Johener-Wruhs评分系统对患肢功能进行评价。[结果]试验组骨折旋转移位角度小于对照组，牵引术后第1、3、7天的VAS疼痛评分均低于对照组，舒适度GCQ总分和其中的生理、心理精神维度单项得分均高于对照组，骨折愈合时间短于对照组，肢体功能Johner-Wruhs评分优良率高于对照组。两组间差异具有统计学意义（P<0.05）。[结论]中西医结合保守治疗胫腓骨骨折过程中应用新型防旋支具，可以有效维持足部中立位，纠正成角及旋转畸形，辅助复位，减轻疼痛，提高患者舒适感受，缩短骨折愈合时间，有利于患肢功能恢复，且不增加并发症的发生，便于护理，安全可靠。

Abstract:

[Objective] To investigate the clinical effect of the new type of anti-rotation orthosis in the integrated traditional Chinese medicine and Western medicine (TCM-WM) conservative treatment of the tibiofibular fractures.[Methods] From September 2015 to January 2017, 64 patients with tibiofibular fractures treated conservatively were randomly divided into the experimental group (32 cases) and the control group (32 cases). Both groups received calcaneal traction after admission. Two groups of patients were all performed calcaneal traction after hospitalization. Chinese orthopedic manipulations were combined with small splint fixation, supplemented by application of Chinese medicine. To prevent foot extorsion, the experimental group was treated with the new type of anti-rotation orthosis, while the control group was treated with routine nursing care. The pain VAS score was performed regularly, and the Kolcaba GCQ was used to evaluate comfort degree. The angle of fracture rotation was measured by CT examination. Fracture healing time and complications were followed up. The Johener-Wruhs scoring system was used to evaluate limb function.[Results] The angle of rotation of the experimental group was smaller than that of the control group. The pain score of VAS in the experimental group was lower than that of the control group at first, third, seventh days after traction. The score of GCQ total score and the mental and mental dimension of the comfort degree were higher than that of the control group. The fracture healing time was shorter than the control group, and the good rate of Johner-Wruhs score of limb function was higher than that of the control group. The difference between the two groups was statistically significant(P<0.05).[Conclusion] In the course of conservative treatment of tibiofibular fracture with integrated TCM-WM, the new type of anti-rotation orthosis can effectively maintain the neutral position of the foot, correct the angle and rotation deformity, assist the reduction, relieve the pain, improve the patient's comfortable feeling, shorten the healing time of the fracture, benefit the recovery of the limb function, and do not increase the occurrence of complications. It is safe and reliable.