经皮克氏针横行支撑固定与顺行髓内固定治疗第5掌骨颈骨折的临床效果比较  

The Clinical Effect Comparison of Percutaneous Kirschner Wire Transverse Support Fixation and Antegrade Intramedullary Fixation in the Treatment of Fifth Metacarpal Neck Fracture

作　　者：李永强 LI Yongqiang(Kangping Peoples hospital,Shenyang,Liaoning,110500)

机构地区：[1]沈阳市康平县人民医院,辽宁康平110500

出　　处：《中国伤残医学》2023年第13期5-9,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：比较分析经皮克氏针横行支撑固定(percutaneous Kirschner wire transverse support fixation,PKWTSF)与顺行髓内固定(antegrade intramedullary fixation,AIF)治疗第5掌骨颈骨折(fifth metacarpal neck fracture,5th MNF)的临床效果,为临床医师选择合理治疗方案提供参考。方法:选择我院2017年7月—2019年6月诊治的188例5th MNF患者为研究对象,依据随机数字表法,将研究对象分为对照组和观察组,每组各94例,对照组患者接受AIF,观察组患者采用PKWTSF。比较2组(2种固定术式)的优良率、手术情况、颈干角情况、骨折愈合时间、手术后上肢功能情况和手功能情况。结果:观察组的优良率较对照组高,但差异不明显,P>0.05;观察组的手术时间比对照组短,但组间差异不明显,P>0.05;观察组的术中透视次数少于对照组,组间存在较大差异,P<0.05;观察组手术后7天、手术后3个月的颈干角均比对照组稍小,组间差异不明显,P>0.05;观察组的骨折愈合时间较对照组短,但组间差异不明显,P>0.05;观察组上肢功能障碍评定量表(Disabilities of the arm,shoulder and hand,DASH)评分较对照组低,手功能评分较对照组高,但组间差异不明显,P>0.05。结论:PKWTSF与AIF治疗5thMNF,均具有良好的临床效果,但PKWTSF在实际操作中简便性更强,术后无需进行外固定,无需再次手术取针,并且还能减少术中透视次数,具有一定的临床推广价值。Objective:To compare and analyze the clinical effect of percutaneous Kirschner wire transverse support fixation(PKWTSF)and antegrade intramedullary fixation(AIF)in the treatment of fth metacarpal neck fracture,so as to provide reference for clinicians to choose reasonable treatment regimen.Methods:A total of 188 patients with fifth metacarpal neck fracture diagnosed and treated in Kangping Peoples hospital from July 2017 to June 2019 were selected as the research subjects.According to the random number table method,the research subjects were divided into two groups:the control group and the observation group(94 cases in each group).The control group received AIF,and the observation group received PKWTSF.The excellent and good rate,operation condition,cervical trunk angle,fracture healing time,upper limb function and hand function after operation were compared between the two groups.Results:The excellent and good rate of the observation group was higher than that of the control group,but the difference was not obvious(P>0.05).The operation time of the observation group was shorter than that of the control group,but there was no significant difference between the two groups(P>0.05);the intraoperative fluoroscopy times of the observation group was less than that of the control group,and there was a big difference between the two groups(P<0.05).The cervical trunk angle of B group was slightly smaller than that of A group at 7d and 3 months after operation,and there was no significant difference between groups(P>0.05).The fracture healing time of the observation group was shorter than that of the control group,but there was no significant difference between the two groups(P>0.05).The scores of disabilities of the arm,shoulder,and hand(DASH)in B group were lower than those in A group,and the hand function scores were higher than those in A group,but the differences were not significant(P>0.05).Conclusion:The PKWTSF and AIF in the treatment of the fth metacarpal neck fracture have good clinical effect,but the PKWTSF is

关 键 词：第5掌骨颈骨折 经皮克氏针横行支撑固定 克氏针顺行髓内固定 临床效果 

分 类 号：R687[医药卫生—骨科学]