| 摘要: |
| 目的:探讨补肾活血汤联合手法复位小夹板固定治疗老年肱骨近端骨折患者的疗效及对肢体功能的影响。方法:选择2018年5月—2020年1月我院收治的老年肱骨近端骨折患者84例，随机分为对照组和观察组，各42例。对照组采用手法复位小夹板固定治疗，观察组在对照组基础上联合补肾活血汤治疗，治疗4周后对患者效果进行评估，比较两组骨折愈合效果、肢体功能、骨折愈合时间、视觉模拟疼痛(VAS)评分、肩关节评分系统Constant-Murley(C-M)评分及治疗预后。结果:治疗4周后，观察组的优良率为92.86%，高于对照组71.43%；观察组的旋前度(88.68±7.56)°、背伸度(89.41±2.43)°、桡偏角度(15.39±2.15)°、掌屈度(42.35±4.61)°及旋后度(80.45±5.98)°均大于对照组[旋前度(81.32±6.42)°、背伸度(68.98±2.35)°、桡偏角度(12.19±2.05)°、掌屈度(45.72±5.32)°及旋后度(84.36±6.01)°]，差异有统计学意义(P<0.05)；观察组治疗2周、4周后的VAS评分分别为(3.11±0.38)分、(1.09±0.21)分，骨折愈合时间为(6.49±0.63)周，均低(短)于对照组2周、4周的VAS评分[(4.59±0.43)分、(3.21±0.33)分]及骨折愈合时间[(9.64±0.81)]，差异有统计学意义(P<0.05)；观察组治疗4周后的畸形愈合、骨折不愈、股骨头坏死、感染及跛行发生率均低于对照组(P<0.05)。结论:补肾活血汤联合手法复位小夹板固定用于老年肱骨近端骨折患者中能提高骨折愈合率，改善患者肢体功能，缩短骨折愈合时间，减轻患者疼痛，改善预后，值得推广应用。 |
| 关键词: 补肾活血汤 手法复位 小夹板固定 老年肱骨近端骨折 肢体功能 |
| DOI：10.3969/j.issn.1007-6948.2021.01.013 |
| 投稿时间：2020-06-15 |
| 基金项目: |
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| Observation on the Therapeutic Effect of Bushen Huoxue Decoction Combined with Manual Reduction of Mall Splint Fixation in Elderly Patients with Proximal Humeral Fractures and its Effect on Limb Function |
| SU Xiao-Tian |
| Department of Orthopaedics, Tianjin TeDa Hospital, Tianjin 300457, China |
| Abstract: |
| Objective To explore the therapeutic effect of Bushen Huoxue Decoction combined with manual reduction and small splint fixation in elderly patients with proximal humeral fractures and its effect on limb function. Methods From May 2018 to January 2020, 84 elderly patients with proximal humeral fractures were selected as subjects. The random number table method was divided into a control group (n= 42 cases) and an observation group (n=42 cases). The control group was treated with manual reduction and small splint fixation. The observation group was treated with Bushen Huoxue Decoction on the basis of the control group. After 4 weeks of treatment, the patient' s effect was evaluated, and the fracture healing effect, limb function, fracture healing time, visual simulated pain (VAS) score, constant-murley (CM) score of shoulder joint scoring system and treatment prognosis were compared. Results The excellent rate of the observation group after 4 weeks of treatment was 92.86% higher than that of the control group of 71.43% (P<0.05); the pronation degree of the observation group after 4 weeks of treatment (88.68±7.56), the degree of back extension (89.41±2.43), radial deflection angle (15.39±2.15), palm flexion (42.35±4.61)? and supination angle (80.45±5.98)are all greater than those of the control group,which pronation angle (81.32±6.42)?, back extension (68.98±2.35)?, radial deviation angle (12.19±2.05)?, palm flexion (45.72±5.32)?and supination degree (84.36±6.01)? (P<0.05). The VAS scores of the observation group at 2 and 4 weeks after treatment were (3.11 ±0.38) points, (1.09±0.21) points respectively. The fracture healing time was (6.49±0.63) weeks, all of which were low (short) and the VAS scores of the control group were (4.59±0.43) points, (3.21±0.33) points and the fracture healing time was (9.64±0.81) weeks (P <0.05). The incidence of deformity healing, fracture healing, femoral head necrosis, infection and claudication after treatment in the observation group were lower than those in the control group after 4 weeks of treatment (P <0.05). Conclusion Bushen Huoxue Decoction combined with manual reduction and small splint fixation for elderly patients with proximal humerus fractures can improve fracture healing rate, improve patient limb function, shorten fracture healing time, reduce patient pain and improve patient prognosis, which is worth popularizing and applying. |
| Key words: Bushen Huoxue Decoction manual reduction small splint ?xation elderly proximal humerus fractures limb function |
