摘要
目的 比较微型指骨外固定支架与微型钢板治疗掌骨头关节内骨折的临床效果,为临床选择手术方案提供理论依据.方法 选取我院2014年3月至2016年3月收治的74例掌骨头关节内骨折患者作为研究对象,均为闭合性骨折,根据治疗方法的不同分为外固定支架组和微型钢板组,每组37例,分别采用微型指骨外固定支架和微型AO钢板治疗,比较两组术中一般情况;术后随访6个月~1年,比较两组掌指关节功能,骨折愈合情况和不良反应发生率.结果 外固定架组术后6个月、1年优良率分别为91.9%（34/37）、97.3%（36/37）,微型钢板组术后6个月、1年优良率分别为73.0%（27/37）、81.2%（30/37）,外固定架组显著高于微型钢板组,差异均有统计学意义（χ2值分别为7.120、7.062,P〈0.05）;外固定架组并发症总发生率为2.7%（1/37）,显著低于微型钢板组的24.3%（9/37）,差异有统计学意义（P=0.014）;外固定架组平均骨折愈合时间为（2.6±0.4）个月,显著低于微型钢板组的（3.1±0.7）个月,差异有统计学意义（t=2.40,P〈0.001）.结论 外固定支架在掌骨头骨折的治疗中,创伤小,可跨关节固定,同时维持很好的固定强度,促进骨折愈合和掌指关节功能的恢复,值得临床推广应用.
Objective To compare the clinical effects of mini phalangeal external fixation and mini plate in the treatment of intraarticular fractures of the metacarpal bone head,and to provide a theoretical basis for clinical selection of surgical plan. Methods Seventy？four cases of metacarpal bone head intraarticular fractures treated in Huizhou People′s Central Hospital from March 2014 to March 2016 were selected as the research object. All cases were closed fractures and were randomly divided into the external fixation group and the mini plate group,37 cases in each group and treated respectively with the mini phalangeal external fixator and mini AO plate. The patients were followed up for 6 months to 1 year,the function of the metacarpophalangeal joint,the union of the fracture and the incidence of side effects were compared between the two groups. Results The excellent rates of the external fixation group at 6 months and I year after operation were 91. 9% （ 34/37） and 97. 3%（ 36/37） respectively,which were significantly higher than those of the mini plate group （ 73. 0%（ 27/37） ,81. 2%（ 30/37 ） ） , the difference was statistically significant （χ2 = 7. 120, 7. 062, P〈0. 05 ） . The complication rate of the external fixation group was 2. 7%（ 1/37） ,which was significantly lower than that of the mini plate group （ 24. 3% （ 9/37 ） ） , the difference was statistically significant （ P=0. 014 ） . The average fracture healing time in the external fixator group was （2. 6±0. 4） months,which was significantly lower than that in the mini plate group （3. 1±0. 7） months,the difference was statistically significant （t=2. 40,P〈0. 001） . Conclusion In the treatment of metacarpal bone head fracture,the external fixation has small trauma,can do cross joint fixation,and maintain a good fixation strength,and promote the healing of fracture and the recovery of metacarpophalangeal joint function. It is worthy of clinical application.
作者
杨福周
易远历
陈奇鸣
黄远清
Yang Fuzhou Yi Yuanli Chen Qiming Huang Yuanqing(Department of Hand and Foot Surgery,Huizhou People＇s Central Hospital, Huizhou 516001, China)
出处
《中国综合临床》
2017年第9期794-797,共4页
Clinical Medicine of China
基金
惠州市科技计划项目（20140802）
关键词
微型钢板
外固定支架
掌骨头骨折
Mini plate
External fixation
Fracture of metacarpal bone head
