Clinical value of ultrasound-guided axillary brachial plexus block combined with traditional Chinese medicine manual reduction and small splint fixation in treatment of distal radius and ulna fractures in children

Yan Yalan; Du Yanshu; Hu Zhenyu; He Pilong; Zhao Chun

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Clinical value of ultrasound-guided axillary brachial plexus block combined with traditional Chinese medicine manual reduction and small splint fixation in treatment of distal radius and ulna fractures in children

更新时间：2026-06-10

- Clinical value of ultrasound-guided axillary brachial plexus block combined with traditional Chinese medicine manual reduction and small splint fixation in treatment of distal radius and ulna fractures in children
- Journal of Chongqing Medical University Pages: 1-8(2026)
- 作者机构：
  
  四川省骨科医院麻醉科，成都 610041
- 作者简介：
- 基金信息：
- DOI：
  CLC： R726.8
- Received：28 December 2025，
  
  Revised：2026-03-04，
  
  Accepted：26 March 2026，
  
  Online First：10 June 2026，
- 稿件说明：
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Yan Yalan,Du Yanshu,Hu Zhenyu,et al.Clinical value of ultrasound-guided axillary brachial plexus block combined with traditional Chinese medicine manual reduction and small splint fixation in treatment of distal radius and ulna fractures in children[J].Journal of Chongqing Medical University,
DOI：

Yan Yalan,Du Yanshu,Hu Zhenyu,et al.Clinical value of ultrasound-guided axillary brachial plexus block combined with traditional Chinese medicine manual reduction and small splint fixation in treatment of distal radius and ulna fractures in children[J].Journal of Chongqing Medical University, DOI：10.13406/j.cnki.cyxb..

摘要

目的

分析超声引导腋路臂丛神经阻滞联合中医手法复位小夹板固定治疗小儿尺桡骨远端骨折的临床价值。

方法

采用单中心前瞻性研究设计。选取2024年7月至2025年6月于四川省骨科医院急诊科且采用“郑氏手法”复位小夹板固定治疗的尺桡骨远端骨折患儿，按家属意愿分为阻滞组（自愿选择复位前行超声引导下腋路臂丛神经阻滞）与非阻滞组（不同意进行超声引导下腋路臂丛神经阻滞），采用倾向性匹配评分以1∶1最近邻匹配法平衡两组患儿基线差异。观察2组患儿东安大略儿童医院疼痛（Children’s Hospital of Eastern Ontario Pain Scale，CHEOPS）评分、麻醉效果、生命体征、治疗情况、关节功能恢复情况［改良Mayo腕关节评分（Modified Mayo Wrist Score，MMWS）］及并发症。

结果

阻滞组复位时、复位结束10 min、离院时的CHEOPS评分均低于非阻滞组（

0.05）；阻滞组复位结束后布洛芬混悬液使用率为2.82%，低于非阻滞组的56.34%（

0.05）；阻滞组的手法复位时间短于非阻滞组（

0.05），解剖复位率高于非阻滞组（

0.05），1周再移位发生率低于非阻滞组（

0.05）；复位期间，2组均未出现脉搏血氧饱和度（saturation of peripheral O₂，SpO₂）

95%的情况，但阻滞组的最低SpO₂低于非阻滞组（

0.05）；阻滞组复位期间的最大心率增幅、最大收缩压（systolic blood pressure，SBP）增幅均低于非阻滞组（

0.05）。小夹板拆除后，阻滞组MMWS总分及功能状态维度的评分均高于非阻滞组（

0.05）。2组患儿的并发症，多为轻微、一过性，且并发症发生率差异无统计学意义（

0.719）。

结论

超声引导腋路臂丛神经阻滞联合中医手法复位小夹板固定治疗小儿尺桡骨远端骨折可明显减轻患儿疼痛及应激反应，提高解剖复位率，降低早期再移位率，有利于腕关节功能恢复。

Abstract

Objective

To investigate the clinical value of ultrasound-guided axillary brachial plexus block combined with traditional Chinese medicine（TCM） manual reduction and small splint fixation in the treatment of distal ulna and radius fractures in children.

Methods

A single-center prospective study was conducted among the children with distal radius and ulna fractures who were treated in Emergency Department of Sichuan Orthopedic Hospital from July 2024 to June 2025 and received Zheng’s manual reduction and small splint fixation. According to the willingness of their family members，they were divided into block group（willing to undergo ultrasound-guided axillary brachial plexus block before reduction） and non-block group （unwilling to undergo ultrasound-guided axillary brachial plexus block）. Propensity score matching was performed using the 1∶1 nearest neighbor matching method to balance baseline differences between the two groups. The two groups were observed in terms of Children’s Hospital of Eastern Ontario Pain Scale（CHEOPS） score，anesthetic effect，vital signs，treatment，joint functional recovery［modified Mayo wrist score（MMWS）］，and complications.

Results

Compared with the non-block group，the block group had a significantly lower CHEOPS score at the time of reduction，10 minutes after reduction，and the time of discharge（

0.05），a significantly lower rate of use of ibuprofen suspension after the end of reduction（2.82% vs. 56.34%，

0.05），a significantly shorter time of manual reduction （

0.05），a significantly higher anatomical reduction rate（

0.05），and a significantly lower incidence rate of redisplacement at 1 week（

0.05）. During reduction，neither group experienced satu

ration of peripheral O₂（SpO

）

95%，but the lowest SpO

in the block group was lower than that in the non-block group（

0.05），and compared with the non-block group，the block group had significantly lower increases in maximum heart rate and maximum systolic blood pressure during reduction（

0.05）. After removal of the small splint，compared with the non-block group，the block group had significantly higher total MMWS score and score of the dimension of functional status（

0.05）. The complications were mostly mild and transient in both groups，and there was no significant difference in the rate of complications between the two groups（

=0.719）.

Conclusion

In the treatment of distal radius and ulna fractures in children，ultrasound-guided axillary brachial plexus block combined with TCM manual reduction and small splint fixation can significantly alleviate pain and stress response，improve anatomical reduction rate，reduce early redisplacement rate，and help to promote the recovery of wrist function.

关键词

Keywords

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