微型外固定支架联合克氏针内固定治疗腕关节开放性粉碎性骨折的临床效果  

Clinical effect of micro external fixator combined with Kirschner wire internal fixation on open comminuted fractures of wrist joint

作　　者：杨玉峰 徐基涛 赵琰 职朝洋 Yang Yufeng;Xu Jitao;Zhao Yan;Zhi Chaoyang(Department of Orthopedics I,Xinxiang Second People’s Hospital,Xinxiang 453000,China)

机构地区：[1]新乡市第二人民医院骨一科,新乡453000

出　　处：《中国实用医刊》2022年第19期5-8,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨微型外固定支架联合克氏针内固定治疗腕关节开放性粉碎性骨折的临床效果。方法抽取2019年6月至2021年6月在新乡市第二人民医院行关节固定治疗的89例腕关节开放性粉碎性骨折患者为研究对象,采用随机数字表法将其分为对照组44例和联合组45例。对照组行克氏针内固定治疗,联合组在对照组基础上联合微型外固定支架治疗。两组均随访6个月,比较两组治疗效果、治疗后骨折恢复指标和关节功能恢复情况[上肢功能障碍评定量表(DASH)、腕关节患者自我评估量表(PRWE),Gart-land-Werley腕关节评分系统]、术后当天和术后6个月关节活动度及并发症发生情况。结果联合组治疗优良率(97.78%,44/45)高于对照组(84.09%,37/44),P<0.05;治疗后,联合组骨折愈合及术后关节可活动时间均短于对照组,且术后6个月联合组DASH、PRWE、Gart-land-Werley评分系统评分均低于对照组(P均<0.05);术后6个月,联合组腕关节背伸、旋前、旋后、掌屈活动度均高于对照组(P均<0.05);联合组并发症发生率为4.44%(2/5),低于对照组的18.18%(8/44),P<0.05,。结论与单纯克氏针内固定治疗相比,联合微型外固定支架治疗腕关节开放性粉碎性骨折的效果更佳,可缩短患者关节功能及活动度的恢复时间,改善预后,安全性高。Objective To investigate the clinical effect of micro external fixator combined with Kirschner wire internal fixation in the treatment of open comminuted fractures of wrist joint.Methods A total of 89 patients with open comminuted fractures of wrist joint who underwent joint fixation in the Xinxiang Second People’s Hospital from June 2019 to June 2021 were enrolled as the research objects,and they were divided into control group(44 cases)and combination group(45 cases)according to random number table method.The control group was treated by Kirschner wire internal fixation,while the combination group was treated by micro external fixtor based on the treatment of the control group.Both groups were followed up for 6 months.The curative effect,related indexes of postoperative recovery,recovery of joint function assessed by disabilities of arm,shoulder and hand(DASH),patient-rated wrist evaluation(PRWE),and Gart-land-Werley wrist scoring system,range of motion on the day after surgery and 6 month after surgery,and the occurrence of complications were compared between the two groups.Results The good rate of treatment in the combination group(97.78%,44/45)was higher than that in the control group(84.09%,37/44),P<0.05.The fracture healing time and postoperative joint motion time in the combination group were shorter than those in the control group,and scores of DASH,PRWE and Gart-land-Werley scoring system were lower than those in the control group 6 month after surgery(all P<0.05).Six month after surgery,back extension,pronation,supination,and palmar flexion of wrist joint in the combination group were higher than those in the control group(all P<0.05).The incidence of complications in the combination group was 4.44%(2/5),lower than 18.18%(8/44)in the control group(P<0.05).Conclusions Compared with internal fixation with Kirschner wire alone,micro external fixation in the treatment of open comminuted fractures of wrist joint is more effective,which can significantly shorten recovery time of joint function and motion,a

关 键 词：骨折 粉碎性 微型外固定支架 克氏针内固定 疗效 关节活动度 关节功能 

分 类 号：R687.3[医药卫生—骨科学]