可塑性磁疗夹板对照治疗柯力氏骨折的临床研究
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摘要
保守疗法治疗柯力氏骨折，手法整复，以可塑性磁疗夹板和普通夹板两种不同器材固定骨折，比较两种夹板固定治疗的疗效。本文分文献研究与临床研究两部分。
文献研究：回顾中医夹板的历史，简单评价当代夹板治疗的新发展。系统学习电磁技术促进骨折愈合的实验研究与临床研究。探讨电磁场影响骨折愈合的机理。提出将磁疗与夹板结合治疗柯力氏骨折可能是一种更好的方法。
临床研究：目的：比较两种夹板治疗柯力氏骨折的疗效。方法：24例柯力氏骨折患者分为两组，处理组13例，对照组11例。均以手法复位，用两种不同的夹板固定。10天后观察两组肿胀及疼痛消退情况。四周后摄片观察骨折愈合情况，比较两组治疗良好率与优秀率。结果：磁疗夹板组消肿效果优于对照组，止痛效果两组无差异。骨折愈合两组良好率无显著差异，优秀率经统计处理有显著差异。
Objective:To explore the action of flexible magnetic splint in the treatment of Colles fracture .
Methods:24 subjects were randomized into 2groups, 13subjects in flexible magnetic splint group and llsubjects in common splint group, with a course of 4 weeks .Take
X-ray radiograph of each cases. Classify the callus
quality into 4 grades. Compare one group with the other in callus quality , degree of swelling reduse and level of pain.
Result:The excellent rate and good rate of callus quality were 69.2%, 92. 3% in flexible magnetic splint group and 27. 3%, 81. 8% in common splint group. Comparing to the later , the former has significantly high level of fracture healing. And the former has higher degree of swelling reduce than the later,but 2groups have no difference in level of pain.
文献研究：回顾中医夹板的历史，简单评价当代夹板治疗的新发展。系统学习电磁技术促进骨折愈合的实验研究与临床研究。探讨电磁场影响骨折愈合的机理。提出将磁疗与夹板结合治疗柯力氏骨折可能是一种更好的方法。
临床研究：目的：比较两种夹板治疗柯力氏骨折的疗效。方法：24例柯力氏骨折患者分为两组，处理组13例，对照组11例。均以手法复位，用两种不同的夹板固定。10天后观察两组肿胀及疼痛消退情况。四周后摄片观察骨折愈合情况，比较两组治疗良好率与优秀率。结果：磁疗夹板组消肿效果优于对照组，止痛效果两组无差异。骨折愈合两组良好率无显著差异，优秀率经统计处理有显著差异。
Objective:To explore the action of flexible magnetic splint in the treatment of Colles fracture .
Methods:24 subjects were randomized into 2groups, 13subjects in flexible magnetic splint group and llsubjects in common splint group, with a course of 4 weeks .Take
X-ray radiograph of each cases. Classify the callus
quality into 4 grades. Compare one group with the other in callus quality , degree of swelling reduse and level of pain.
Result:The excellent rate and good rate of callus quality were 69.2%, 92. 3% in flexible magnetic splint group and 27. 3%, 81. 8% in common splint group. Comparing to the later , the former has significantly high level of fracture healing. And the former has higher degree of swelling reduce than the later,but 2groups have no difference in level of pain.
引文
[1] 尚天裕医学文集，第1版，北京：中国科技出版社，1991。
[2] Kershaw CJ, Cunningham JL, Kewright J. Tibial external fixation, weight bearing and fracture movement. Clin Orthop, 1993,293:28-36.
[3] Sarmiento A, Mckellop HA, Llinas A, et al, Effect of loading and fructure, motions on diaphyseal tibial fracture. J Orthop Res, 1996,14:80-84.
[4] 王以进，长管状骨的弹性性质实验研究。中国生物医学工程学报，1986，5(3)：157。
[5] 董福惠，小夹板固定治疗骨折生物力学研究。尚天裕医学文集，第1版，北京：中国科技出版社，1991，748。
[6] 赵勇，尚天裕，钟红刚。骨折愈合的应力适应性研究，中国骨伤，1994，7(3)：16。
[7] Comell CN, Lane JM, Newesy factor in fracture healing, Clin Orthop, 1992,227:229-239
[8] Goodship AE, Cunningham JL, Kenwright J. Strain rate and timing of stimulation in mechaaical modulation of fracture healing. Clin Orthop, 1998, 335:105
[9] 李保泉，丁锷，刘安平。可塑性药物夹板治疗四肢骨折疗效观察，中医正骨，1997，9(2)，13。
[10] 洪锡平，王斌。战救夹板及敷带的革新。人民军医，2002，2
[11] 吴午，马宝安，袁存华。铁丝夹板牵引治疗掌指骨骨折，实用骨科杂志，2002，8(3)，178。
[12] 续力民，康树林，李海亭，等。体内磁场促进骨折愈合的实验研究，北京军区医药，1994，5：329-331。
[13] 杜伟中，顾奕。自制指形石膏夹板治疗指掌骨骨折，海南医学，2000，11(5)，42。
[14] 张雪芬，黄琳珍，罗小霞．新型尼龙搭扣小夹板在治疗四肢骨折病人中
的应用．护理学杂志，2000，15(12)，720。
[15] 王万春，黄兆民。磁性接骨板对骨折的愈合研究，中华理疗杂志，1995，18：71-73。
[16] 王化京，邢荣珍，石福明。孟氏骨折复位固定器配合小夹板治疗胫腓骨骨折32例。中国骨伤，2000，13(12)，750。
[17] 陈义君，王琦。闭合穿针结合夹板、托板、弹力带治疗肱骨骨折，河南医药信息，2000，8(7)，18。
[18] 许晓民，经皮钳夹配合小夹板固定治疗不稳定型胫腓骨骨折。中医正骨，2000，12(10)，46。
[19] 王泽云 龚化阳 赵修江，尺骨鹰嘴悬吊牵引加小夹板外固定治疗严重移位肱骨髁上骨折91例，光明中医2003，18(109)，61。
[20] 于斌，牵引加小夹板外固定治疗儿童股骨干骨折31例，中国骨伤，2001，14(3)，190。
[21] 王亦璁，骨与关节损伤，第三版，北京：人民卫生出版社，2002。
[22] 卢致顺 李志腾 余焕豪，跟骨牵引加小夹板外固定治疗胫骨远端粉碎性骨折41例，中国中医骨伤科杂志，2002，10(3)，49。
[23] Yasuda I, Noguchi K, Sata T. Mechanical callus and electrical callus. J Jpn Orthop Assoc, 1954;28:267
[24] Friedenberg ZB, Harlow MC, Brighton CT. Healing of nonunion of the medial malleolus by means of direct current: Case report. J Trauma, 1971;11:883.
[25] Bassett CAL, Pilla AA, Pawluk RJ. A non-operative salvage of surgically-resistant pseudarthrosis and non-unions by pulsing electromagnetic fields. A preliminary report. Clin Orthop, 1977;124:128.
[26] 李起鸿，柳凤轩，孙石安等。直流电刺激促进骨折愈合的实验研究与临床应用。中华外科杂志，1983；21(8)：501
[27] Lechner F, Ascherl R, Kraus W. Treatment of pseudarthrosis with electrodynamic potentials of low frequency range. Clin
Orthop. 1981;161:71.
[28] Heckman JD, Ingram AJ, Loyd RD et al. Nonunion treatment with pulsed electromagnetic fields. Clin Orthop, 1981;161:58.
[29] Archer CW, Ratcliffe NA. The effect of pulsed magnetic fields on chick embryo cartilaginous skeletal rudiments in vitro. J Exp Zool,1983:225:243.
[30] Fitzsimmons RJ, Farley J, Adey WR et al, Embryonic bone matrix formation is increased after exposure to a low-amplitude capacitively coupled electric field, in vitro. Biochim Biophys Acta, 1986;882:51.
[31] Fitzsimmons RJ, Farley JR, Adey WR et al. Frequency Dependence of increased cell proliferation, in vitro, in exposures to a low-ampliyude, low-frequency electric field: Evidence for dependency on increased mitogen activity released into culture medium. J of Cell Physio, 1989;139:586.
[32] Sollazzo V, Traina GC, DeMattei M et al. Responses of human MG-63 osteosarcoma cell line and human ostesblast-like cells to pulsed electromagnetic fields. Bioelectromagnetics, 1997;18:541.
[33] Hongming Zhuang, Wei Wang, Richard MS et al. Electrical stimulation induces the level of TGF-β1 mRNA in osteoblastic cells by a mechanism involving calcium/calmodulin pathway. Biochem Biophys Res Commun, 1997;237:229.
[34] Luben RA, Cain CD, Chen MC et al. Effects of electromagnetic stimuli on bone and bone cells in vitro: inhibition of responses to parathyroid hormone by low-energy low-frequency fields. Proc Natl Acad Sci USA, 1982;79:4180.
[35] Fitzsimmon RJ, Strong DD, Mohan S et al. Low-amplitude, low-frequency electric field-stimulated bone cell proliferation may in part be mediaed by increased IGF-Ⅰ release, J of Cell Physiol, 1992;150:84.
[36] Goodman EM, Greenebaum B, Marron MT. Altered protein synthesis in a cell-free system exposured to a sinusoidal magnetic field. Biochim Biophys Acta, 1993;1202:107.
[37] Blank M, Goodman R. Do electromagnetic fields intreract directly with DNA? Bioelectromagnetics, 1997;18:111.
[38] Borsalino G, Bagnacani M, Bettati E, et al. Electrical stimulation of human femoral intertrochanteric osteomiea: double blind study. J, Clih Orthoop, 1988,237:256-263.
[39] Sharrard WJW, A double-blind trial of pulsed electromagnetic field for delayed union of tibial fractures. J Bone Jiont Surg, 1990, 72B (3): 347-355.
[40] Mammi CI, Cocchi R, Cadossi R, et al. Effect of PEMF on the healing of human tibial, osteomies: a double blind study. J. Clin Orthop, 1993, 288:246-253.
[41] Scott G, King JB. A prospective double blind trial of electrical capacitive coupling in the treatment of nonunion of long bones. J Bone JointSurg, 1994,76A(6):820-826.
[42] Brighton OT, Shaman P, Hepenstall RB, et al. Tibial nonunion treated withdirect current, capacitive coupling or bone graft. J Clin Orthop, 1995,321:223-224.
[43] Adams BD, Trykman GK, Taleisnik J. Treatment of scaphoid nonunion with casting and pulsed electromagnetic fields: a study continuation. J Hand Surg, 1992,17A(7):910-914.
[2] Kershaw CJ, Cunningham JL, Kewright J. Tibial external fixation, weight bearing and fracture movement. Clin Orthop, 1993,293:28-36.
[3] Sarmiento A, Mckellop HA, Llinas A, et al, Effect of loading and fructure, motions on diaphyseal tibial fracture. J Orthop Res, 1996,14:80-84.
[4] 王以进，长管状骨的弹性性质实验研究。中国生物医学工程学报，1986，5(3)：157。
[5] 董福惠，小夹板固定治疗骨折生物力学研究。尚天裕医学文集，第1版，北京：中国科技出版社，1991，748。
[6] 赵勇，尚天裕，钟红刚。骨折愈合的应力适应性研究，中国骨伤，1994，7(3)：16。
[7] Comell CN, Lane JM, Newesy factor in fracture healing, Clin Orthop, 1992,227:229-239
[8] Goodship AE, Cunningham JL, Kenwright J. Strain rate and timing of stimulation in mechaaical modulation of fracture healing. Clin Orthop, 1998, 335:105
[9] 李保泉，丁锷，刘安平。可塑性药物夹板治疗四肢骨折疗效观察，中医正骨，1997，9(2)，13。
[10] 洪锡平，王斌。战救夹板及敷带的革新。人民军医，2002，2
[11] 吴午，马宝安，袁存华。铁丝夹板牵引治疗掌指骨骨折，实用骨科杂志，2002，8(3)，178。
[12] 续力民，康树林，李海亭，等。体内磁场促进骨折愈合的实验研究，北京军区医药，1994，5：329-331。
[13] 杜伟中，顾奕。自制指形石膏夹板治疗指掌骨骨折，海南医学，2000，11(5)，42。
[14] 张雪芬，黄琳珍，罗小霞．新型尼龙搭扣小夹板在治疗四肢骨折病人中
的应用．护理学杂志，2000，15(12)，720。
[15] 王万春，黄兆民。磁性接骨板对骨折的愈合研究，中华理疗杂志，1995，18：71-73。
[16] 王化京，邢荣珍，石福明。孟氏骨折复位固定器配合小夹板治疗胫腓骨骨折32例。中国骨伤，2000，13(12)，750。
[17] 陈义君，王琦。闭合穿针结合夹板、托板、弹力带治疗肱骨骨折，河南医药信息，2000，8(7)，18。
[18] 许晓民，经皮钳夹配合小夹板固定治疗不稳定型胫腓骨骨折。中医正骨，2000，12(10)，46。
[19] 王泽云 龚化阳 赵修江，尺骨鹰嘴悬吊牵引加小夹板外固定治疗严重移位肱骨髁上骨折91例，光明中医2003，18(109)，61。
[20] 于斌，牵引加小夹板外固定治疗儿童股骨干骨折31例，中国骨伤，2001，14(3)，190。
[21] 王亦璁，骨与关节损伤，第三版，北京：人民卫生出版社，2002。
[22] 卢致顺 李志腾 余焕豪，跟骨牵引加小夹板外固定治疗胫骨远端粉碎性骨折41例，中国中医骨伤科杂志，2002，10(3)，49。
[23] Yasuda I, Noguchi K, Sata T. Mechanical callus and electrical callus. J Jpn Orthop Assoc, 1954;28:267
[24] Friedenberg ZB, Harlow MC, Brighton CT. Healing of nonunion of the medial malleolus by means of direct current: Case report. J Trauma, 1971;11:883.
[25] Bassett CAL, Pilla AA, Pawluk RJ. A non-operative salvage of surgically-resistant pseudarthrosis and non-unions by pulsing electromagnetic fields. A preliminary report. Clin Orthop, 1977;124:128.
[26] 李起鸿，柳凤轩，孙石安等。直流电刺激促进骨折愈合的实验研究与临床应用。中华外科杂志，1983；21(8)：501
[27] Lechner F, Ascherl R, Kraus W. Treatment of pseudarthrosis with electrodynamic potentials of low frequency range. Clin
Orthop. 1981;161:71.
[28] Heckman JD, Ingram AJ, Loyd RD et al. Nonunion treatment with pulsed electromagnetic fields. Clin Orthop, 1981;161:58.
[29] Archer CW, Ratcliffe NA. The effect of pulsed magnetic fields on chick embryo cartilaginous skeletal rudiments in vitro. J Exp Zool,1983:225:243.
[30] Fitzsimmons RJ, Farley J, Adey WR et al, Embryonic bone matrix formation is increased after exposure to a low-amplitude capacitively coupled electric field, in vitro. Biochim Biophys Acta, 1986;882:51.
[31] Fitzsimmons RJ, Farley JR, Adey WR et al. Frequency Dependence of increased cell proliferation, in vitro, in exposures to a low-ampliyude, low-frequency electric field: Evidence for dependency on increased mitogen activity released into culture medium. J of Cell Physio, 1989;139:586.
[32] Sollazzo V, Traina GC, DeMattei M et al. Responses of human MG-63 osteosarcoma cell line and human ostesblast-like cells to pulsed electromagnetic fields. Bioelectromagnetics, 1997;18:541.
[33] Hongming Zhuang, Wei Wang, Richard MS et al. Electrical stimulation induces the level of TGF-β1 mRNA in osteoblastic cells by a mechanism involving calcium/calmodulin pathway. Biochem Biophys Res Commun, 1997;237:229.
[34] Luben RA, Cain CD, Chen MC et al. Effects of electromagnetic stimuli on bone and bone cells in vitro: inhibition of responses to parathyroid hormone by low-energy low-frequency fields. Proc Natl Acad Sci USA, 1982;79:4180.
[35] Fitzsimmon RJ, Strong DD, Mohan S et al. Low-amplitude, low-frequency electric field-stimulated bone cell proliferation may in part be mediaed by increased IGF-Ⅰ release, J of Cell Physiol, 1992;150:84.
[36] Goodman EM, Greenebaum B, Marron MT. Altered protein synthesis in a cell-free system exposured to a sinusoidal magnetic field. Biochim Biophys Acta, 1993;1202:107.
[37] Blank M, Goodman R. Do electromagnetic fields intreract directly with DNA? Bioelectromagnetics, 1997;18:111.
[38] Borsalino G, Bagnacani M, Bettati E, et al. Electrical stimulation of human femoral intertrochanteric osteomiea: double blind study. J, Clih Orthoop, 1988,237:256-263.
[39] Sharrard WJW, A double-blind trial of pulsed electromagnetic field for delayed union of tibial fractures. J Bone Jiont Surg, 1990, 72B (3): 347-355.
[40] Mammi CI, Cocchi R, Cadossi R, et al. Effect of PEMF on the healing of human tibial, osteomies: a double blind study. J. Clin Orthop, 1993, 288:246-253.
[41] Scott G, King JB. A prospective double blind trial of electrical capacitive coupling in the treatment of nonunion of long bones. J Bone JointSurg, 1994,76A(6):820-826.
[42] Brighton OT, Shaman P, Hepenstall RB, et al. Tibial nonunion treated withdirect current, capacitive coupling or bone graft. J Clin Orthop, 1995,321:223-224.
[43] Adams BD, Trykman GK, Taleisnik J. Treatment of scaphoid nonunion with casting and pulsed electromagnetic fields: a study continuation. J Hand Surg, 1992,17A(7):910-914.
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