摘要
目的 :探讨超声在掌骨颈骨折手法复位牵引治疗中的临床价值。方法 :自2013年4月至2016年8月在超声引导下手法复位牵引托板固定治疗30例掌骨颈骨折患者,其中男26例,女4例;年龄14~56(25.6±1.6)岁;病程7 h^5 d(2.7±0.6)d。第5掌骨颈骨折20例,第4、5掌骨颈骨折7例,第2掌骨颈骨折3例。观察并比较骨折愈合情况、双侧头干角角度﹑掌指关节主动活动范围,并采用DASH评分进行功能评价。结果:除3例胶布脱落放弃治疗外,27例均获得随访,时间6~11(7.2±0.8)个月。骨折均获愈合,愈合时间5~8(5.6±0.4)周。随访时患侧头干角(15.1±1.8)°与健侧头干角(13.5±2.8)°比较差异无统计学意义(t=1.54,P>0.05);患侧掌指关节主动活动度(86.3±2.6)°与健侧(91.8±1.6)°比较差异无统计学意义(t=1.16,P>0.05)。术后7个月患肢DASH评分为4.3±1.5。结论 :超声引导下闭合复位掌骨颈骨折,可实时、动态观察骨折对位情况,患者接受度高,是治疗掌骨颈骨折的可行方法。
Objective： To study clinical efficacy of manual reduction and traction fixation for the treatment of metacarpal neck fracture under ultrasound-guided. Methods： From April 2013 to August 2016,30 patients with metacarpal neck fractures were treated with manual reduction and traction fixation under ultrasound-guided,including 26 males and 4 females aged from 14 to 56 years old with an average of （25.6±1.6） years old,the courses of diseases ranged from 7 h to 5 d with an average of （2.7±0.6） d. Twenty patients were the fifth metacarpal neck fracture,7 patients were the 4th and 5th metacarpal neck fractures,3 patients were the second metacarpal neck fracture. Fracture healing,angle of bilateral head shaft angle and active range of metacarpophalangeal joints was measured,and DASH score was applied to evaluate function. Results： Twenty-seven patients were followed up from 6 to 11 months with an average of（7.2±0.8） months. Fracture were healed from 5 to 8 weeks with an average of （5.6±0.4） weeks. The affected shaft angle was （15.1±1.8）°,and health head shaft angle was （13.5±2.8）°,while there was no significant difference （t=1.54,P〉0.05）. The affected range motion of metacarpophalangealjoint was（86.3±2.6）°,health active range motion of metacarpophalangeal joint was（91.8±1.6）°,and no significant difference between both side （t=1.16,P〉0.05）. DASH score was 4.3±1.5 at 7 months after operation. Conclusion： Manual reduction and traction fixation for the treatment of metacarpal neck fracture under ultrasound-guided could dynamic observe fracture position in time,high patients＇ acceptability and is a feasible method for the treatment of metacarpal neck fracture.
作者
王孝辉
张彩丽
沈素红
郭绍勇
李德
WA NG Xiao-hui, ZHA NG Cai-li, SHEN Su-hong, GUO Shao-yong, LI De.(Department of Microsurgery, Luoyang Orthopedic Hospital of Henan Province ,Luoyang d71002, Henan, Chin)
出处
《中国骨伤》
CAS
2018年第3期254-256,共3页
China Journal of Orthopaedics and Traumatology
基金
河南省中医药科学研究专项重点课题(编号:2016ZY1011)~~
关键词
超声检查
正骨手法
牵引术
掌骨
骨折固定术
Uhrasonography
Bone setting manipulation
Traction
Metacarpal bones
Fracture fixation
