三种不同内固定方法治疗掌指骨骨折的疗效比较  

Comparison of Therapeutic Effects of Three Different Kinds of Internal Fix-ation Methods in the Treatment of Metacarpal and Phalangeal Fracture

作　　者：唐琪[1] 朱付平[1] 董克芳[2] 孙之镐[3] 卢敏[3] 李卫宁[3] 

机构地区：[1]中南大学湘雅二医院骨科,湖南长沙410011 [2]湖南中医学院第二附属医院骨科 [3]湖南中医学院第一附属医院骨科

出　　处：《南华大学学报（医学版）》2007年第6期840-842,共3页Journal of Nanhua University(Medical Edition)

摘　　要：目的比较分析应用克氏针、钢丝捆扎和微型钢板三种内固定方法治疗掌指骨骨折的疗效。方法83例101处掌、指骨骨折,其中A组35例47处采用克氏针内固定;B组22例25处采用钢丝捆扎内固定;C组26例29处采用微型钢板螺钉内固定。分别从手术时间、术后关节功能恢复情况、骨折愈合时间、并发症的发生进行分析比较。结果A组TAFS评分优良率61.7%;B组96.0%;C组79.3%。三组进行比较,差异均有统计学意义(P<0.01)。结论对损伤程度不同的掌指骨骨折应分别选用不同的内固定物,掌指骨干稳定性骨折病人可以选择钢丝捆扎内固定,其他类型的骨折尽量选用AO微型钢板,克氏针内固定应尽量少用。Objective To compare and analyse effects of three kinds of internal fixation methods using K wire, steel wire bundle up and mini - plate in the treatment of metacarpal and phalangeal fracture. Methods The clinical data of 101 metacarpal and phalangeal fractures in 83 cases were treated, in which 47 fractures in 35 cases of group A were treated by open reduction and internal fixation with Kirschner wire, 25 fractures in 22 cases of group B were treated by open reduction and internal fixation with steel wire bundle up, 29 fractures in 26 cases using open reduction and internal fixation with mini - steel plate bolt. The operation time, recovery condition of joint function after operation of 3 groups were analyzed and compared. Results By the standard of TAFS the fineness ratio of group A, group B, and group C were respectively 61.7%, 96.0% and 79.3%. Comparing the outcomes among the above 3 groups, their disparation all have statistical significance（P 〈 0.01）. Conclusion The metacarpus and phalange fracture in different degree of injury should adopt suitable internal fixation object. Steel wire bundle up in internal fixation can be used in stable fracture of metacarpal and phalangeal fracture, AO mini-steel plate can be used in other types of fractures, internal fixation using Kirschner wire ought to be used less.

关 键 词：掌骨骨折 指骨损伤 骨折固定术 内固定器 

分 类 号：R683.41[医药卫生—骨科学]