两种方法治疗Bennett骨折的病例对照研究  

Case-control study on two different methods in the treatment of Bennett fractures

作　　者：赖震[1] 石仕元[1] 魏威[1] 费骏[1] 余涌杰[1] 

机构地区：[1]浙江省中西医结合医院骨科,浙江杭州310003

出　　处：《中国骨伤》2011年第6期479-481,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:比较石膏固定和骨片钉固定两种方法治疗Bennett骨折的疗效。方法:对2005年5月至2009年6月收治的31例分别接受2种方法治疗的Bennett骨折患者资料进行回顾性分析,其中石膏固定组(A组)17例,男12例,女5例;平均年龄(43.9±5.7)岁;骨折按Buechler分型:1区3例,2区11例,3区3例。骨片钉固定组(B组)14例,男8例,女6例;平均年龄(45.6±6.1)岁;骨折按Buechler分型:1区3例,2区9例,3区2例。观察比较两组患者:①住院时间,骨折愈合时间,固定失败情况;②骨折复位质量采用KjaerPetersen等方法进行对比分析;③拇指运动功能采用Cannon等方法进行评判。结果:31例均获随访,时间6～15个月,平均(9.0±3.5)个月,A、B组平均住院时间分别为(7.0±2.5)d和(9.0±3.9)d,A组住院时间短。术后骨折复位质量:A组优4例,良8例,差5例;B组优8例,良6例,差0例,B组复位质量优于A组。A、B组平均骨折愈合时间分别为(6.0±0.5)周和(6.0±1.9)周,两种治疗方法差异无统计学意义(P>0.05)。术后3个月拇指运动功能:A组优6例,良8例,可3例;B组优8例,良5例,可1例,两种治疗方法差异无统计学意义(P>0.05)。A组出现骨折再次移位2例,B组无固定失败病例。结论:两种治疗方法均获得满意疗效,石膏固定具有操作简便、无创伤的优点,但稳定性差,容易发生骨折再移位;骨片钉固定具有固定牢固、术后功能恢复好的优点,但手术创伤大,住院时间长。Objective：To compare the clinical outcomes between two different methods in the treatment of Bennett fractures.Methods：From May 2005 to June 2009,31 patients with Bennett fractures were treated with gypsum and percutaneous fragment pin fixation.In gypsum fixation group,there were 17 cases including 12 males and 5 females with an average age of （43.9±5.7） years;according to Buechler classification：3 cases were Ⅰ region fracture,11 cases were Ⅱregion fracture,3 cases were Ⅲ region fracture.In percutaneous fragment pin fixation group,there were 14 cases including 8 males and 6 females with an average age of （45.6±6.1） years;according to Buechler classification：3 cases were Ⅰregion fracture,9 cases were Ⅱregion fracture and 2 cases were Ⅲ region fracture.The observing and comparing items of the two groups included：① length of stay,time of fracture healing,failure of fixation;②postoperative radiographs comparison according to method of Kjaer-Petersen;③cannon scores used for outcome measurement.Results：All the patients in the two groups were followed up,the duration ranged from 6 to 15 months,with an average of（9.0±3.5） months.The length of stay were （7.0±2.5） d in gypsum fixation group and （9.0±3.9） d in percutaneous fragment pin fixation group with statistically significant differences（P0.05）.The postoperative reduction quality according to method of Kjaer-Petersen,in gypsum fixation group：4 patients got an excellent result,8 good and 5 poor;in percutaneous fragment pin fixation group,the above data were 8,6 and 0 respectively;there were statistically significant differences（P0.05）between the two groups.The time of fracture healing were （6.0±0.5） weeks in gypsum fixation group and （6.0±1.9） weeks in percutaneous fragment pin fixation group with no statistically significant differences（P0.05）.Cannon scores were evaluated at postoperative 3 months,in gypsum fixation group：6 patients got an excellent result,8 good and 3 fair;in percutaneous

关 键 词：BENNETT骨折 内固定器 外固定 病例对照研究 

分 类 号：R683.41[医药卫生—骨科学]