超声引导下闭合复位克氏针横向固定治疗掌骨骨折的临床疗效  

Clinical Efficacy of Ultrasonic Guided Closed Reduction K-Wires Transverse Internal Fixation for Metacarpal Fracture

作　　者：李雅丽 诸寅[2] 晏飞[1] 姜洪涛[1] 冯向春[1] 付世杰[1] LI Yali(The Affiliated Hospital of Chengde Medical University,Hebei Chengde 067000,China)

机构地区：[1]承德医学院附属医院,河北承德067000 [2]北京积水潭医院手外科,北京100035

出　　处：《河北医学》2023年第4期636-641,共6页Hebei Medicine

基　　金：2021年度河北省医学科学研究课题计划,(编号:20210562)。

摘　　要：目的:探讨超声引导下闭合复位克氏针横向内固定治疗掌骨骨折的临床疗效。方法:对2017年3月至2020年3月在我院治疗的84例掌骨骨折患者资料进行回顾性分析,观察组36例采用超声引导下闭合复位克氏针横向内固定术,术后第1天开始手指主动屈伸功能锻炼,4~6周复查X线拔除克氏针。对照组48例采用微型钢板内固定术,术后第1天开始手指主动屈伸功能锻炼,1、2、3、6个月复查X线。结果:术后84例患者全部获得随访,随访时间12~18个月,平均14.6个月,无感染、畸形愈合及延迟愈合等严重并发症。观察组手术时间、术中出血量、骨折愈合时间、住院时间明显低于对照组(P<0.05),手指屈伸总活动度(TAM)法评定优良率为100%,对照组优良率为100%,两组无明显差异(P>0.05)。结论:超声引导下闭合复位克氏针横向内固定治疗掌骨骨折简便易操作,辐射少,创伤小,出血少,手术时间短,骨折愈合快,尤其适用于孕妇及青少年,值得推广应用。Objective:To investigate the clinical efficacy of ultrasonic guided closed reduction K-wires transverse internal fixation for metacarpal fracture.Methods:The data of 84 patients with metacarpal fractures treated in our hospital from March 2017 to March 2020 were retrospectively analyzed.The observation group of 36 patients were treated with closed reduction K-wires transverse internal fixation under ultrasound guidance,and active flexion and extension of fingers began on the first postoperative day.X-ray was re-examined 4-6 weeks after surgery and the K-wires were removed.In the control group,48 patients received internal fixation with mini-plate,active flexion and extension functional exercise of fingers began on the first postoperative day,and X-ray was reviewed at 1st,2nd,3rd,6th months.Results:Patients operated on the fracture of metacarpal bones were followed up for 12-18 months,with an average of 14.6 months.There were no serious complications such as infection,malformation or delay in healing.The observation group had significant advantages over the control group in operation time,intraoperative blood loss,fracture healing time and hospital stay(P<0.05).Total motion of flexion and extension(TAM)was used to assess hand function.The excellent and good rate was 100%in observation group.The excellent and good rate of the control group was also 100%.There was no significant difference between the two groups(P>0.05).Conclusion:Ultrasonic guided closed reduction K-wires transverse fixation in the treatment of metacarpal fracture is simple and easy to operate,with less radiation,less trauma,less bleeding,short operation time,and fast fracture healing,especially for pregnant women and teenagers,and it is worthy of clinical promotion.

关 键 词：掌骨骨折 闭合复位 克氏针 微型钢板 超声 

分 类 号：R687.3[医药卫生—骨科学]