中医正骨2025，Vol.37Issue(12)：14-20,7.
郑氏束带法复位指钢托外固定治疗肿胀期近节指骨骨折的临床研究
A clinical study of Zheng's bandage reduction and finger steel splint external fixation for treatment of proxi-mal phalangeal fractures in the swollen phase
摘要
Abstract
Objective:To evaluate the clinical efficacy of Zheng's bandage reduction and finger steel splint external fixation in treat-ment of proximal phalangeal fractures in the swollen phase.Methods:Sixty-four patients with swollen-phase proximal phalangeal fractures,recruited from November 2022 to November 2023,were randomized into 2 groups,with 32 ones in each group,and they were treated with Zheng's bandage reduction and finger steel splint external fixation(Zheng's bandage reduction group),as well as conventional manual re-duction and the same external fixation(conventional manual reduction group),respectively.Immediately post-reduction,the quality of frac-ture reduction was assessed according to the reduction criteria outlined in Operative Hand Surgery and the related standards established by HAN Xu et al.The activity function of the affected finger was evaluated using the total active movement(TAM)method,as stipulated in the Trial Standard for Functional Evaluation of the Upper Limbs developed by the Hand Surgery Society of the Chinese Medical Association,im-mediately post-removal of external fixator and at 3-month follow-up.Moreover,the hand function was assessed using the patient-rated wrist/hand evaluation(PRWHE),including PRWHE pain score and PRWHE function score,before the reduction,immediately post-removal of external fixator and at the 3-month follow-up.Results:Two patients each in the 2 groups withdrew from the trial.①Quality of fracture reduc-tion.The quality of fracture reduction was better in Zheng's bandage reduction group compared to conventional manual reduction group im-mediately post-reduction((R)zheng's bandage reduction group=25.42,(R)conventional manual reduction group=35.58,Z=-2.624,P=0.009).②TAM.The TAM showed no significant difference between the 2 groups immediately post-removal of external fixator(Z=-1.090,P=0.276),while,3 months following the removal of external fixator,it was higher in Zheng's bandage reduction group compared to the conventional manual reduction group((R)zheng's bandage reduction group=27.02,(R)conventional manual reduction group=33.98,Z=-2.151,P=0.031).③PRWHE pain score.The PRWHE pain score showed no significant difference across different time points before and after the reduction(F=1.091,P=0.301),but it was lower in Zheng's bandage reduction group compared to conventional manual reduction group(F=3 787.703,P=0.000).④PRWHE function score.The PRWHE function score presented a decreasing trajectory over time in the 2 groups(F=1 804.544,P=0.000;F=2 778.929,P=0.000).The PRWHE function score showed no significant difference between the 2 groups before the reduction,while,immediately following the removal of external fixator and at 3-month follow-up,it was lower in Zheng's bandage reduction group compared to conventional manual reduction group(t=-3.873,P=0.000;t=-2.916,P=0.005).Conclusion:Zheng's bandage reduction and finger steel splint external fixation can enhance the immediate reduction quality,alleviate the pain,improve the active function of the affect-ed finger,and promote the hand function recovery in treatment of swollen-phase proximal phalangeal fractures.Its therapeutic efficacy is su-perior to that of conventional manual reduction with the same fixation.关键词
骨折/手指骨/牵引术/正骨手法/骨折固定术/随机对照试验专题Key words
fractures,bone/finger phalanges/traction/bone setting manipulation/fracture fixation/randomized controlled trials as topic引用本文复制引用
李玮琳,袁荣霞,但柟林,谢正虎..郑氏束带法复位指钢托外固定治疗肿胀期近节指骨骨折的临床研究[J].中医正骨,2025,37(12):14-20,7.基金项目
四川省中医药管理局科学技术研究专项课题(2023MS577) （2023MS577）
