Objective: To compare the effects of closed reduction under non-anesthesia and axillary brachial plexus block on patients with distal radius fractures. Methods: From May 2021 to May 2023, 88 patients aged 0~16 years old who underwent distal radius fracture treatment in Beijing Jishuitan Hospital Guizhou Hospital were selected and randomly divided into control group (44 patients) and experimental group (44 patients). The control group underwent closed reduction under non-anesthesia, the experimental group underwent closed reduction under axillary brachial plexus block. Mean artery pressure (MAP), mean heart rate and mean respiration were measured. The wrist joint activity before and after reduction was recorded. Visual Analogue Scale (VAS) was used to evaluate the degree of patients' own pain. The success rate of reduction and the incidence of complications in the two groups were recorded. Results: After reduction, the MAP, mean heart rate and mean respiration level in the experimental group were lower than those in the control group (P＜0.05). The levels of radial bias angle, palm curvature, pronation and supination in the experimental group were higher than those in the control group (P＜0.05). The VAS score level at the immediate, 12 h, 24 h and 48 h postoperative period in the experimental group was lower than that in the control group (P＜0.05). The reduction success rate in the experimental group was higher than that in the control group (P＜0.05). The overall complication rate was slightly higher in the experimental group than that in the control group (P＞0.05). Conclusion: Compared with closed reduction under non-anesthetic state, closed reduction under axillary brachial plexus block can reduce blood pressure, heart rate, respiration and pain in children with distal radius fracture, improve their wrist function and success rate of reduction, with high safety.
Zhou Kailiang
,
Wu Shengzhong
,
Lin Lianyang
,
Huang Zhiyong
,
Guo Shengfeng
. Comparison of the effect of closed reduction under non-anesthetic and axillary brachial plexus block on patients with distal radius fractures[J]. Journal of Baotou Medical College, 2024
, 40(11)
: 50
-54
.
DOI: 10.16833/j.cnki.jbmc.2024.11.011
[1] Nypaver C, Bozentka DJ. Distal radius fracture and the distal radioulnar joint[J]. Hand Clin, 2021, 37(2): 293-307.
[2] Shapiro LM, Kamal RN, Management of Distal Radius Fractures Work Group, et al. Distal radius fracture clinical practice guidelines-updates and clinical implications[J]. J Hand Surg Am, 2021, 46(9): 807-811.
[3] Sengab A, Krijnen P, Schipper IB. Risk factors for fracture redisplacement after reduction and cast immobilization of displaced distal radius fractures in children: a meta-analysis[J]. Eur J Trauma Emerg Surg, 2020, 46(4): 789-800.
[4] Kim KH, Duell B, Munnangi S, et al. Radiographic predictors of delayed carpal tunnel syndrome after distal radius fracture in the elderly[J]. Hand (NY), 2022, 17(4): 652-658.
[5] Østergaard HK, Mechlenburg I, Launonen AP, et al. The benefits and harms of early mobilization and supervised exercise therapy after non-surgically treated proximal humerus or distal radius fracture: a systematic review and meta-analysis[J]. Curr Rev Musculoskelet Med, 2021, 14(2): 107-129.
[6] 肖鸿鹄, 李庭, 米萌, 等. 加速康复外科在创伤骨科无痛闭合整复桡骨远端骨折的前性队列研究[J]. 中华创伤骨科杂志, 2019, 21(11): 945-951.
[7] 但汉威, 沈宁博, 叶东婷. 右美托咪定联合罗哌卡因在腋路臂丛神经阻滞中的应用[J]. 临床合理用药杂志, 2022, 15(25): 116-118.
[8] 中华医学会骨科学分会创伤骨科学组, 中华医学会骨科学分会外固定与肢体重建学组. 中国成人桡骨远端骨折诊疗指南(2023)[J]. 中华创伤骨科杂志, 2023, 25(1): 6-13.
[9] 阎旭艳, 郝红, 卢丽莎. 甲哌卡因联合不同浓度罗哌卡因在断指再植患者腋路臂丛神经阻滞中的应用效果及其对感觉、运动神经阻滞恢复时间的影响[J]. 临床合理用药杂志, 2021, 14(36): 153-155.
[10] 刘颖. B超引导下臂丛神经阻滞麻醉用于上肢手术的麻醉效果探讨[J]. 中国医疗器械信息, 2023, 29(10): 90-92.
[11] 陈天鑫, 张智龙, 杨胜平, 等. 手法复位小夹板固定治疗桡骨远端骨折的可视化分析[J]. 中国医药导报, 2022, 19(36): 86-91.
[12] 张建龙, 刘丁铭, 冯太升, 等. 加味复元活血汤联合手法复位夹板外固定治疗桡骨远端骨折的疗效观察[J]. 成都医学院学报, 2022, 17(3): 316-319,323.
[13] 刘亚君, 张明哲, 刘文平, 等. 超声引导下锁骨上臂丛神经阻滞在桡骨远端骨折患者手术中的应用效果观察[J]. 山东医药, 2021, 61(11): 59-62.
[14] 张联, 张华. 老年桡骨远端粉碎性骨折患者术中B超引导下臂丛神经阻滞麻醉的效果观察[J]. 广西医科大学学报, 2018, 35(5): 696-699.
[15] 余刚, 余利军, 吴华杰. 平乐郭氏正骨联合小夹板外固定对老年桡骨远端骨折患者掌倾角及腕关节功能的影响[J]. 中国中西医结合外科杂志, 2023, 29(3): 322-326.
[16] 曹哲铭, 李志刚, 曾祥悦, 等. 逐瘀通络法配合腕关节镜下锁定加压钢板内固定治疗桡骨远端骨折患者腕关节活动功能及疼痛介质的影响[J]. 世界中西医结合杂志, 2022, 17(1): 151-156.
[17] 黄晓夏, 贾麒钰, 伊尔夏提·克力木, 等. 保留旋前方肌完整性联合掌侧锁定钢板内固定治疗桡骨远端骨折[J]. 中国组织工程研究, 2023, 27(31): 4959-4964.
[18] 贾雪原, 周明, 吴永伟, 等. 加长型万向锁定桡骨远端双柱接骨板治疗桡骨远端合并干部骨折的临床疗效[J]. 中华手外科杂志, 2023, 39(2): 97-101.
