微型钢板与外固定支架治疗指骨骨折的疗效比较  

Curative effect companson of microplate and external fixation frame in treating phalanx fracture

作　　者：罗伟丰 刘晓春[2] 牟勇[2] 陈鹏程 LUO Weifeng;LIU Xiaochun;MOU Yong(Department of Surgery,Second People's Hospital of Guangdong,Guangzhou,Guangdong,510000,China)

机构地区：[1]广东省第二人民医院民航院区外科,广东广州510000 [2]广东省第二人民医院创伤骨科,广东广州510317

出　　处：《实用手外科杂志》2021年第4期439-441,454,共4页Journal of Practical Hand Surgery

摘　　要：目的探讨微型钢板内固定与外固定支架治疗指骨骨折的临床效果。方法回顾2014年1月-2020年1月收治的指骨骨折患者30例,其中采用指骨微型钢板内固定治疗16例,采用外固定支架固定治疗14例。对比分析两组在手术时间、住院时间、骨折愈合时间、术后并发症发生率及功能恢复方面的差异。结果两组固定方式、住院时间、影像学资料、骨折愈合时间、并发症发生率对比差异无统计学意义,但手术时间比较两组差异具有统计学意义,外固定支架固定组手术时间明显短于微型钢板内固定组。微型钢板内固定组中2例出现并发症均为伤口愈合不良,通过术后换药达到愈合;外固定支架组中4例出现并发症均为钉道感染,给予钉眼滴酒精等对症处理后感染得到控制。两组术后TAFS评分对比,微型钢板内固定组术后优良率为87.5%,外固定支架固定组优良率为92.86%,两组比较差异无统计学意义。结论微型钢板与外固定支架治疗指骨骨折各有优劣。但对关节内指骨骨折建议采用外固定支架固定,而对于简单类型的指骨骨折,可根据医师习惯及实际情况进行选择。Objective To investigate the clinical effect of internal fixation with micro plate and external fixation for phalanx fracture.Methods A total of 30 patients with phalanx fracture admitted to our department from January 2014 to January 2020 were reviewed.Among them,16 patients were treated with phalanx micro plate,and 14 patients were treated with external fixation frame.The differences in operation time,hospital stay,fracture healing time,incidence of postoperative complications and functional recovery between two groups were compared and analyzed.Results There were no significant differences in the length of hospital stay,the time of radiological fracture healing and the incidence of complications between two groups.However,there were statistically significant differences in the operative time between two groups.The operative time of the external fixation group was significantly shorter than that of the plate fixation group.In the plate fixation group,2 patients with complications were all suffering from poor wound healing,which healed by dressing change after surgery.In the external fixation group,4 patients with complications were all suffering from nail tract infection,which was controlled after symptomatic treatment such as alcohol drops on the nail eye.Comparison of TAFS scores of patients with phalanx fracture after operation in group A showed that the excellent and good rate of the micro phalanx plate internal fixation group was 87.5%,and the excellent and good rate of the external fixation group was 92.86%.There was no statistical significance between two groups.Conclusion Both microphalanx plate and microexternal fixator have their advantages and disadvantages in the treatment of phalanx fracture.However,the author believes that for intra-articular phalanx fractures,it is recommended to adopt more micro external fixation frame,while for simple phalanx fractures,the choice can be made according to the physician's habit and actual situation.

关 键 词：指骨骨折 微型钢板 外固定支架 

分 类 号：R687.3[医药卫生—骨科学]