C型臂X线机引导下闭合复位穿针固定切开复位内固定治疗闭合性指骨骨折的临床疗效  

Clinical Efficacy of Closed Reduction and Pin Fixation Under the Guidance of C-Arm X-Ray Machine and Open Reduction and Internal Fixation in the Treatment of Closed Phalangeal Fractures

作　　者：池昊天 杨国勇 唐晓俞 汪志 吴冰霜 CHI Haotian;YANG Guoyong;TANG Xiaoyu(Chengdu First Orthopaedic Hospital, Sichuan Chengdu 610000, China)

机构地区：[1]四川省成都第一骨科医院运动医学科,四川成都610000

出　　处：《河北医学》2022年第6期934-939,共6页Hebei Medicine

基　　金：四川省干部保健科研课题,(编号:川干研2020-605);四川省骨科医院科研项目,(编号:2019ZD06)。

摘　　要：目的:观察C型臂X线机引导下闭合复位穿针固定、切开复位内固定治疗闭合性指骨骨折的临床疗效。方法:选取2017年4月至2021年4月期间我院131例闭合性指骨骨折患者作为研究对象,采用非随机同期对照及患者自愿原则进行分组,其中70例实施C型臂X线机引导下闭合复位采用穿针固定,纳入观察组,61例实施切开复位内固定,纳入对照组。比较两组复位成功率,手术相关指标(手术时间、骨折愈合时间),术后并发症发生情况及术后6个月手关节总活动度(TAM)恢复情况。结果:两组复位成功率差异无统计学意义(P>0.05);观察组手术时间、骨折愈合时间均短于对照组(P<0.05);观察组术后感染、内固定松动总发生率低于对照组(P<0.05);观察组术后6个月TAM评价优良率高于对照组(P<0.05)。结论:C型臂X线机引导下闭合复位穿针固定与切开复位内固定对闭合性指骨骨折复位效果相当,但患者术后骨折愈合更快,功能恢复更佳,并发症更少。Objective:To observe the clinical efficacy of closed reduction and pin fixation under the guidance of C-arm X-ray machine and open reduction and internal fixation in the treatment of closed phalangeal fractures.Methods:A total of 131 patients with closed phalangeal fractures in the hospital between April 2017 and April 2021 were selected as the research subjects and were grouped according to the non-randomized concurrent control and principle of voluntariness of patients.Among them,70 cases underwent closed reduction and pin fixation under the guidance of C-arm X-ray machine and were included in observation group,and 61 cases underwent open reduction and internal fixation and were enrolled as control group.The reduction success rate,surgery-related indicators(surgical time,fracture healing time),occurrence of postoperative complications and total active motion(TAM)recovery of hand joints at 6 months after surgery were compared between the two groups.Results:There was no statistical significance in the reduction success rate between the two groups(P>0.05).The surgical time and fracture healing time in observation group were shorter than those in control group(P<0.05).The total incidence rate of postoperative infection and internal fixation loosening was lower in observation group than that in control group(P<0.05).The excellent and good rate of TAM evaluation in observation group was higher than that in control group at 6 months after surgery(P<0.05).Conclusion:Closed reduction and pin fixation under the guidance of C-arm X-ray machine has the same reduction effect with open reduction and internal fixation on closed phalangeal fractures,but the former one has faster postoperative fracture healing,better functional recovery and fewer complications.

关 键 词：C型臂X线机 闭合复位穿针固定 切开复位内固定 闭合性指骨骨折 

分 类 号：R68[医药卫生—骨科学]