可塑性微型角钢板内固定治疗复杂的掌指骨髁间、髁上骨折的临床研究  

Clinical study on complicated metacarpal and phalangeal intercondylar and supracondylar fractures by internal fixation with ductile mini-angle-plate

作　　者：洪洋[1] 钱光[1] 姜海莹[1] 董有海[1] 程根祥[1] 杨群[1] 童文卿[1] 

机构地区：[1]复旦大学附属第五人民医院骨科,上海200240

出　　处：《上海医学》2007年第3期179-181,F0002,共4页Shanghai Medical Journal

摘　　要：目的探讨可塑性微型角钢板内固定治疗复杂的掌指骨髁间、髁上骨折的疗效。方法将2001年12月至2005年12月我科收治的136例(187个部位)掌指骨髁间、髁上骨折患者分成可塑性微型角钢板内固定组(A组)、异型AO钛钢板组(B组)和克氏针交叉联合固定治疗组(C组),比较3组患者的手术时间、骨折愈合、关节恢复及术后并发症发生情况。结果3组患者手术及骨折愈合时间的差异均无统计学意义(P值均＞0．05)。A、B组术后关节恢复显著优于C组(P值均＜0．05),A、B组间差异无统计学意义(P＞0．05)。3组术后愈合不良发生率的差异无统计学意义(X^2=4．73,P＞0．05)。A、B组术后感染、疼痛发生率均显著低于C组(X^2=6．91、14．45,P值均＜0．05),A、B组间差异无统计学意义(P值均＞0．05)。3组间关节僵硬发生率差异有统计学意义(X^2=25．45, P＜0．05)。结论可塑性微型角钢板内固定治疗复杂的掌指骨髁间、髁上骨折的临床疗效较好,并发症相对较少。Objective To appraise the therapeutic effects of ductile mini-angle-plate and AO atypia mini-Tiplate and Kirschner-wind internal fixation for the above mentioned fractures. Methods We collected 187 regional complicated metacarpal and phalangeal intercondylar and supracondylar fractures treated by ductile mini-angleplate, AO Atypia mini Ti-plate and Kirschner-wind internal fixation methods, and evaluated the postoperative wound infection, malunion of fracture, a nchylosis, postoperative pain and recovery of hand function. Results Ductile mini-angle-plate group： 71 cases were followed-up and 10 cases were lost of follow-up. AO atypia mini Tiplate group： 68 cases were followed-up. Kirschner-wine group： 38 cases were followed-up. All patients healed at an average of 5 months. On comparisons of postoperative wound infection, postoperative pain, and a nchylosis among the three groups, ductile mini-angle-plate group was the best whereas Kirschner-wind group was the worst （P 〈 0.05）. There was no significant difference in malunion of fracture （P 〉 0.05）. Conclusions Ductile mini-an gle-plate has the superiority over others on stable internal fixation, less influence on the articular capsule. The patients can have early exercise with relatively less complication, thus being more effective with better results. （Shanghai Med J, 2007, 30：179-181）

关 键 词：掌骨 指骨 骨折 角钢板 内固定 

分 类 号：R687.3[医药卫生—骨科学]