摘要
目的掌指骨骨折是手外科常见创伤性疾病,掌指骨参与腕掌、掌指、指间关节的构成,治疗不当将严重影响患者的手的功能。文中探讨微型钢板、穿髓克氏针固定、牵引位石膏托3种不同治疗方法在掌指骨骨折治疗中的临床疗效。方法选取掌指骨骨折患者60例共95个部位,分别平均进入微型钢板内固定、穿髓克氏针固定及牵引位石膏托3种不同治疗方法组,术后随访6～12个月,平均随访(8.1±1.5)个月,按照总主动屈曲度系统(total active flexion system,TAFS)评分评估3组临床疗效。结果微型钢板组内固定优良率为90.9%,穿髓克氏针内固定组优良率为71.4%,牵引位石膏保守治疗组优良率为55.6%,3组结果差异有显著统计学意义(P<0.05)。骨折愈合时间微型钢板组较其他2组短,差异有统计学意义(P<0.05)。切开复位感染率微型钢板内固定组为0.0%,穿髓克氏针组为15.4%(P<0.05)。结论微型钢板内固定治疗掌指骨骨折在术后关节功能恢复、骨折愈合时间、术后感染预防方面都具有明显优势,是首选的治疗方法。
Objective Metacarpal and phalangeal fractures are common traumatic diseases in hand surgery. Metacarpal and phalangeal bones are involved in the carpometacarpal joints, metacarpophalangeal joints and interphalangeal joints and, if improperly treated, will seriously affect the function of the hand. This study was to compare the clinical effects of miniature plate fixation, K-wire fixation, and traction plaster in the treatment of metacarpal and phalangeal fractures. Methods We equally assigned 60 patients with 95 metacarpal and phalangeal fractures to three groups to be treated with miniature plate fixation, K-wire fixation and traction plas- ter, respectively. We followed up the patients for 6 - 12 （8.1 ~ 1.5 ） months and evaluated the clinical effects of the three methods using the total active flexion system （TAFS）. Results The excellence rates of treatment were 90.9% in the miniature plate group, 71.4% in the K-wire group and 55.6% in the traction plaster group, with statistically significant differences among the three （P 〈 0.05 ）. The miniature plate method achieved the shortest healing time as compared with the other two （P 〈 0.05）. The infection rate of open reduction was significantly lower in the miniature plate fixation than in the K-wire fixation group （0.0% vs 15.4%, P 〈 0.05）. Conclusion Miniature plate fixation is a preferable option for the management of metacarpal and phalangeal fractures for its obvious advantages faster joint function recovery, shorter fracture healing time, and easier postoperative infection prevention.
出处
《医学研究生学报》
CAS
北大核心
2012年第10期1045-1047,共3页
Journal of Medical Postgraduates
基金
全军"十一五"重点课题(06G043)
