掌骨髓内针及置入辅助装置的设计及初步临床应用  

Design and preliminary clinical application of metacarpal intramedullary needle and placement auxiliary device

作　　者：邓玖征[1] 朱剑津[1] 袁野[1] 何大炜[1] 赵喆[1] 潘勇卫[1] Deng Jiuzheng;Zhu Jianjin;Yuan Ye;He Dawei;Zhao Zhe;Pan Yongwei(Department of Orthopedics,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine of Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院骨科,清华大学临床医学院,北京102218

出　　处：《中华手外科杂志》2022年第6期487-491,共5页Chinese Journal of Hand Surgery

基　　金：北京市科学技术委员会医药协同科技创新研究(科研)项目(Z181100001918030)。

摘　　要：目的设计掌骨髓内针套件(包括符合中国人解剖特点的掌骨髓内针和辅助置入装置),并探索其临床试用效果。方法根据前期中国人掌骨解剖数据研究结果,设计掌骨髓内针套件,并应用于临床7例(试验组),与同一时期手工自制髓内针(对照组)的治疗效果相对比。比较两组手术时间、术中透视次数、复位前后以及骨折愈合后的头干角、掌指关节主动活动范围。结果术后随访3~6个月,平均(4.2±1.3)个月。试验组手术时间7~27min,平均(13.86±4.02)min。对照组手术时间14~26min,平均(19.80±3.94)min,两组间差异有统计学意义(t=3.04,P<0.01);试验组透视次数18~35次,平均(25.00±5.20)次,对照组透视24~35次,平均(29.80±3.12)次,两组差异有统计学意义(t=2.39,P=0.03);试验组术前颈干角(49.29±13.03)°,术后(15.71±1.11),愈合后(15.43±0.98)°,对照组术前颈干角(51.20±10.45)°,术后(15.00±1.76)°,愈合后(15.50±1.90)°,两组间术前、术后及愈合后颈干角对比,差异无统计学意义。两组患者手背几乎无瘢痕,试验组掌指关节活动范围患侧(75.71±6.63)°,健侧(76.29±6.92)°,两侧对比差异无统计学意义(t=1.18,P=0.28)。对照组掌指关节活动范围患侧(77.60±9.07)°,健侧(78.60±7.81)°,两侧对比差异无统计学意义(t=1.67,P=0.13)。结论我们设计的掌骨髓内针套件有临床应用价值。髓内针能有效维持掌骨颈骨折复位,临床效果良好。辅助置入装置能安全高效置入髓内针。Objective To design a metacarpal intramedullary needle set(include metacarpal intramedullary needle and auxiliary placement devices conforming to the anatomical characteristics of Chinese people),and to explore its clinical trial efficacy.MethodsAccording to the results of the previous research on the anatomical data of Chinese metacarpal bone,a set of metacarpal intramedullary needle was designed and applied to 7 cases(trial group),which was compared with the therapeutic effect of hand-made intramedullary needles(control group)in the same period.The operation time,intraoperative fluoroscopy times,head trunk angle before and after reduction and fracture healing and active range of motion of metacarpophalangeal joints were compared between the two groups.Results The patients were follow-up for 3 to 6 months with an average of(4.2±1.3)months.The operation time in the trial group was 7 to 27 min,with an average of(13.86±4.02)min.In the control group,the operation time was 14 to 26 min,with an average of(19.80±3.94)min.The difference between the two groups was statistically significant(t=3.04,P<0.01).The number of fluoroscopy in the trial group was 18 to 35 times,with an average of(25.00±5.20)times,and that in the control group was 24 to 35 times,with an average of(29.80±3.12)times.The difference between the two groups was statistically significant(t=2.39,P=0.03).The head trunk angle in the trial group was(49.29±13.03)°before operation,(15.71±1.11)°after operation,(15.43±0.98)°after healing,and the head trunk angle in the control group was(51.20±10.45)°before operation,(15.00±1.76)°after operation,and(15.50±1.90)°after healing.There was no statistical difference in the head trunk angle before operation,after operation and after healing betwen the two groups.There was almost no scar on the dorsal hands in the two groups.In the trial group,the range of motion of the metacarpophalangeal joint was(75.71±6.63)°on the affected side and(76.29±6.92)°on the healthy side.There was no statistical difference

关 键 词：掌骨 骨折 髓内固定 闭合复位 经皮固定 

分 类 号：R687.3[医药卫生—骨科学]