改良双克氏针切开复位内固定法与传统术式治疗撕脱骨折型锤状指患者近远期疗效比较  

Comparison on short-term and long-term curative effect of modified double Kirschner wire open reduction and internal fixation and traditional surgery on patients with mallet fingers of avulsion fracture type

作　　者：卢跃奔 徐鸿杰 余俊华 Lu Yueben;Xu Hongjie;Yu Junhua(Department of Hand Surgery,Yongkang Orthopaedic Hospital,Yongkang 321300,China)

机构地区：[1]浙江省永康市骨科医院手外科,321300

出　　处：《中国医师杂志》2021年第1期68-71,76,共5页Journal of Chinese Physician

基　　金：永康市科学技术局计划项目(201729)。

摘　　要：目的比较改良双克氏针切开复位内固定法与传统术式治疗撕脱骨折型锤状指患者的近远期疗效。方法回顾性选取2016年1月至2018年10月永康市骨科医院收治的85例撕脱骨折型锤状指患者,45例患者接受改良双克氏针切开复位内固定手术纳入观察组,40例患者接受传统抽出钢丝法固定手术纳入对照组。记录患者手术时间、骨折愈合时间、并发症,术后3个月评价近期疗效,术后随访1年进行指关节功能评分评价远期预后。结果观察组手术时间短于对照组(P<0.05),观察组骨折愈合时间短于对照组(P<0.05)。观察组优良率为93.33%,高于对照组的77.50%(P<0.05)。在指关节功能评分中,观察组患者的手指力量、手指灵活性、对工作和生活的影响得分及总分均高于对照组(P<0.05);两组疼痛程度、外观满意度比较差异无统计学意义(P>0.05)。两组患者术后并发症发生率比较差异无统计学意义(P>0.05)。结论改良双克氏针切开复位内固定法治疗撕脱骨折型锤状指,操作简单,骨折愈合快,远近期疗效优于传统抽出钢丝法。Objective To compare short-term and long-term curative effect of modified double Kirschner wire open reduction and internal fixation(ORIF)and traditional surgery on patients with mallet fingers of avulsion fracture type.Methods Eighty-five patients with mallet fingers of avulsion fracture type who were admitted to Yongkang Orthopaedic Hospital from January 2016 to October 2018 were enrolled.45 patients received modified double Kirschner wire ORIF were included in the observation group,while 40 patients who underwent traditional extracting wire fixation were included into control group.The operation time,fracture healing time and complications were recorded.At 3 months after surgery,short-term curative effect was evaluated.After 1-year postoperative follow-up,long-term prognosis was evaluated by finger joint function scoring.Results The operation time of observation group was shorter than that of control group(P<0.05).The fracture healing time of observation group was shorter than that of control group(P<0.05).The good rate of observation group was higher than that of control group(93.33%vs 77.50%)(P<0.05).In finger joint function score,scores of finger strength,finger flexibility,effects on work and life,and total score in observation group were higher than those in control group(P<0.05).There was no significant difference in pain degree or appearance satisfaction betwen the two groups(P>0.05).There was no significant difference in incidence of postoperative complications between the two groups(P>0.05).Conclusions The modified double Kirschner wire ORIF for the treatment of avulsion fracture mallet finger has the advantages of simple operation,fast fracture healing and better long-term and short-term curative effect than the traditional wire extraction method.

关 键 词：骨折 撕脱性 锤状指 骨固定钢丝 骨折切开复位 

分 类 号：R687.3[医药卫生—骨科学]