超声引导下闭合复位微创固定治疗掌指骨骨折  

Ultrasound-guided minimal invasive fixation for metacarpus and phalange fractures

作　　者：沈素红 王孝辉 付卓 

机构地区：[1]河南省洛阳正骨医院(河南省骨科医院)功能检查科,河南洛阳471000 [2]河南省洛阳正骨医院(河南省骨科医院)手显微外科,河南洛阳471000

出　　处：《中国医学影像技术》2018年第2期293-296,共4页Chinese Journal of Medical Imaging Technology

基　　金：河南省中医药科学研究重点课题(2016ZY1011)

摘　　要：目的探讨高频超声引导掌指骨骨折闭合复位微创固定治疗的价值。方法选取26例急性期掌指骨骨折患者,随机分为试验组及对照组,每组13例。对试验组采用超声引导下闭合复位固定,对照组采用C形臂X线透视辅助下复位固定。对2组进行随访,观察疗效。结果试验组骨折闭合复位成功率为76.92%(10/13),对照组成功率为84.62%(11/13),差异无统计学意义(χ~2=0,P=1.00)。试验组术中平均C形臂投照次数为(0.62±1.19)次,对照组为(3.46±0.78)次,差异有统计学意义(t=-7.21,P<0.01)。试验组骨折平均愈合时间为(5.45±0.64)周,对照组为(5.71±0.78)周;试验组手指总主动活动度(TAM)优良率为84.62%(11/13),对照组为92.31%(12/13);试验组平均握力为(32.22±2.44)kg;对照组为(34.11±2.74)kg,差异均无统计学意义(P均>0.05)。结论高频超声引导掌指骨骨折闭合复位微创治疗疗效可靠且可减少X线辐射。Objective To explore value of high-frequency ultrasound-guided minimally invasive fixation treatment for metacarpus and phalange fractures. Methods Totally 26 patients of acute metacarpus and phalange fractures were selected and randomly divided into experimental group and control group （each n = 13）. The patients in experimental group underwent ultrasound guided closed reduction, while in control group underwent C-arm X-ray fluoroscopy-guided reduction. Then the patients in two groups were followed up, and the curative effect of both methods were observed. Results The successful rate of closed reduction was 76.92% （10/13） in experimental group, while was 84.62% （11/13） in control group （X^2=0, P= 1.00）. C-arm fluoroscopy was performed （0.62±1.19） times in experimental group, and （3.46-1-0.78） times in control group （t=--7.21, P〈0.01）. The average healing time of fracture was （5.45±0.64） weeks in experimental group and （5.71±0.78） weeks in control group. The excellent and good rate of total active motion （TAM） was 84.62% （11/13） in experimental group and 92.31% （12/13） in control group, respectively. The average grip strength was （32.22±2.44） kg in experimental group, and （34.11±2.74） kg in control group （all P〈0.05）. Conclusion High frequency ultrasound-guided minimally invasive fixation is reliable in treatment of metacarpal and phalangeal fractures, which can significantly reduce X-ray radiation.

关 键 词：超声检查 掌骨 指骨 骨折 骨 骨折闭合复位 外科手术 最小侵入性 

分 类 号：R683.4[医药卫生—骨科学] R445.1[医药卫生—外科学]