微型钢板螺钉内固定与单纯闭合骨折内固定术在手部掌指骨骨折中的疗效比较  

Comparison of internal fixation with micro-plate screw and simple closed fixation for metacarpal and phalangeal fracture

作　　者：谢玉山 谭文思 XIE Yushan;TAN Wensi(Department Orthopaedic Surgery,Zhongkai People＇s Hospital of Huizhou City,Huizhou,Guangdong,516229,China)

机构地区：[1]惠州仲恺高新人民医院骨科,广东惠州516229 [2]惠州市第一人民医院手足、血管外科,广东惠州516001

出　　处：《实用手外科杂志》2018年第2期181-183,190,共4页Journal of Practical Hand Surgery

基　　金：惠州市科技计划项目(项目编号:2017Y055)

摘　　要：目的分析微型钢板螺钉内固定与单纯闭合骨折内固定术对手部掌指骨骨折的临床治疗效果,为治疗手部掌指骨骨折提供理论依据。方法选取2014年5月-2016年5月接受手术治疗的手部掌指骨骨折60例,随机分为观察组与对照组。对照组采用单纯闭合固定法,观察组根据复位后的情况选择合适的微型钢板螺钉进行治疗,分析比较两组住院时间、骨折愈合时间、手术时间、关节屈曲度、满意度等指标。结果观察组优良率93.3%,显著高于对照组优良率53.3%,差异有统计学意义(P<0.05);观察组患者住院时间和手术时间明显长于对照组,差异有统计学意义(P<0.0 5);观察组开始功能训练时间和骨折愈合时间均明显短于对照组,差异有统计学意义(P<0.0 5);观察组关节屈曲度明显大于对照组,差异有统计学意义(P<0.05);观察组关节僵硬、固定物不良反应和骨折延迟愈合发生率明显低于对照组,差异有统计学意义(P<0.05);两组肌腱粘连和术后感染发生率差异无统计学意义(P>0.05);观察组对治疗的满意率为93.3%,明显高于对照组对治疗的满意率60.0%,差异有统计学意义(P<0.05)。结论在患者手部掌指骨骨折治疗中采用微型钢板螺钉方法较单纯闭合骨折内固定术疗效更为显著,恢复时间短,手部功能恢复更快,并发症发病率更低,整体满意度更高。Objective To provide a theoretical basis for the treatment of metacarpal and phalangeal fractures of the hand by comparing the effect of internal fixation with micro-plate screw fixation and simple closed fixation on the treatment of metacarpal and phalangeal fractures. Methods From May 2014 to May 2016, 60 patients with metacarpal and phalangeal fractures were treated with surgical treatment. According to the random number method, all cases were divided into the study group and the control group, each group adiTfitted 30 patients, the control group simple closed fixation, the study group was fixed by appropriate micro-plate and screws according to the situation after the replacement, the time of hospitalization, fracture healing time, operation time, joint flexion degree and satisfaction degree were compared between the two groups. Results The excellent and good rate of the study group was 93.3%, which was significantly higher than that of the control group 53.3% （P 〈0.05）; the fracture heading time in the study group was shorter than the control group, the difference was statistical （P 〈0.05）. The degree of joint flexion was significantly higher in the study group than in the control group （P 〈0.05）. The difference between two groups was statistically significant （P 〈0.05）. The incidence of joint stiffness, fixation adverse event and delayed healing of fracture were significantly lower. The tendon adhesion andpostoperative infection （P 〉0.05）. The satisfaction rate of the treatment group was higher than that in the control group （P 〈0.05 ）. Conclusion The use ofmicro-plate screw in the treatment of metacarpal and phalangeal fractures is more effective than the simple closed fixation, the recovery time is shorter, the recovery of the hand function is faster, the complication rate is lower, the overall satisfaction degree higher degree.

关 键 词：微型钢板螺钉 内固定术 掌指骨骨折 

分 类 号：R687.3[医药卫生—骨科学]