拔伸旋转结合反折屈腕尺偏手法整复与小夹板固定治疗伸直型桡骨远端骨折的近期疗效分析

Analysis of Short-Term Efficacy of Traction-Rotation Combined with Counter-Flexion Wrist Ulnar Deviation Manual Reduction and Small Splint Fixation in the Treatment of Colles’ Fractures

摘要: 目的：探讨采用拔伸旋转结合反折屈腕尺偏手法整复联合小夹板外固定治疗伸直型桡骨远端骨折的临床疗效。方法：回顾性分析2023年1月至2024年12月收治的135例伸直型桡骨远端骨折患者资料。所有患者均采用规范手法复位及小夹板固定。观察治疗后复位与稳定质量、临床疗效(腕关节功能Gartland-Werley评分)、疼痛程度(VAS评分)、症状改善用时(疼痛缓解、肿胀消退、骨折愈合)以及住院时间。结果：其中133例患者复位成功，Gartland-Werley评分显示优98例(73.68%)，良27例(20.30%)，可6例(4.51%)，差2例(1.50%)，治疗优良率为93.98%。末次随访时VAS评分由术前(6.85 ± 1.32)分降至(1.52 ± 0.68)分(P < 0.05)。患者局部疼痛缓解时间为(4.26 ± 1.15) d，腕部肿胀消退时间为(7.35 ± 1.84) d，骨折愈合时间为(48.52 ± 5.67) d，平均住院时间为(9.82 ± 2.41) d。结论：拔伸旋转结合反折屈腕尺偏手法整复与小夹板固定治疗伸直型桡骨远端骨折能快速缓解症状，减轻疼痛，显著改善腕关节功能，疗效确切，值得临床推广应用。

Abstract: Objective: To investigate the clinical efficacy of manual reduction utilizing a combination of traction-rotation and counter-flexion wrist ulnar deviation techniques, followed by external fixation with small splints, for the treatment of Colles’ fractures (extension-type distal radius fractures). Methods: A retrospective analysis was conducted on the clinical data of 135 patients with Colles’ fractures who were admitted between January 2023 and December 2024. All patients underwent standardized manual reduction followed by fixation using small splints. The primary outcomes assessed included the quality of reduction and stability, clinical efficacy evaluated by the Gartland-Werley wrist functional score, pain intensity measured by the Visual Analogue Scale (VAS), time to symptomatic improvement (including pain relief, swelling subsidence, and fracture healing), and the length of hospital stay. Results: Successful reduction was achieved in 133 patients. According to the Gartland-Werley score at the final follow-up, outcomes were rated as excellent in 98 cases (73.68%), good in 27 cases (20.30%), fair in 6 cases (4.51%), and poor in 2 cases (1.50%), resulting in a combined excellent and good rate of 93.98%. The VAS score significantly decreased from a preoperative value of (6.85 ± 1.32) points to (1.52 ± 0.68) points at the final follow-up (P < 0.05). The average time to local pain relief was (4.26 ± 1.15) days, the time for wrist swelling to subside was (7.35 ± 1.84) days, the fracture healing time was (48.52 ± 5.67) days, and the average hospital stay was (9.82 ± 2.41) days. Conclusion: The combined technique of traction-rotation and counter-flexion wrist ulnar deviation manual reduction, followed by small splint fixation, is an effective treatment for Colles’ fractures. This method facilitates rapid symptom relief, significant pain reduction, and marked improvement in wrist function, demonstrating definite short-term efficacy. It is considered a valuable non-invasive approach worthy of broader clinical application.