手部骨折患者远期预后的影响因素及不同固定方法的效果比较  

The influencing factors of long-term prognosis in patients with hand fractures and the clinical value comparison of different fixation methods

作　　者：刘传志 温丽珍 冯小英 LIU Chuan-zhi;WEN Li-zhen;FENG Xiao-ying(Ganzhou Rongjiang New Area Huimin Hospital,Ganzhou 341401,Jiangxi;Shicheng County Traditional Chinese Medicine Hospital,Shicheng 342700,Jiangxi;Ganxian District People's Hospital of Ganzhou City,Ganxian 341100,Jiangxi)

机构地区：[1]赣州蓉江新区惠民医院,江西赣州341401 [2]石城县中医院,江西石城342700 [3]赣州市赣县区人民医院,江西赣县341100

出　　处：《安徽医专学报》2023年第6期49-51,共3页Journal of Anhui Medical College

基　　金：赣州市指导性科技计划项目(编号:20222ZDX9235)。

摘　　要：目的:探讨手部骨折患者远期预后的影响因素及对不同固定方法的临床价值进行比较。方法:选取医院收治的70例手部骨折患者作为研究对象,通过随机数字表法分为A组(35例)和B组(35例),A组患者接受有限内固定结合微型外固定架治疗,B组患者接受克氏针与石膏固定治疗。对比两组患者的不同干预效果;展开为期2年的随访,根据患者的手部功能恢复情况分析预后良好和预后不良组一般资料,并进行logistic回归分析影响手部功能恢复的危险因素。结果:相较于B组患者,A组患者TAM活动度显著更高(P<0.05);相较于B组患者,A组患者VAS评分显著更低,SF-36评分显著更高(P<0.05);Logistic回归分析结果显示,患者AO分型为C型、存在同侧其余骨折和术中骨折复位评估不满意均是影响患者远期手部关节功能预后的独立危险因素(P<0.05)。结论:对于手部骨折患者,有限内固定结合微型外固定架的治疗效果高于克氏针与石膏固定治疗,同时AO分型、同侧其余骨折和术中骨折复位评估均是患者远期手部功能预后的影响因素。Objective:To study the influencing factors of long-term prognosis in patients with hand fractures and compare the clinical value of different fixation methods.Method:70 patients with hand fractures admitted to hospital were selected as the research subjects.They were randomly divided into Group A(n=35)and Group B(n=35)by random number table method,and were respectively treated with limited internal fixation combined with micro external fixation,internal Kirchner needle and plaster fixation.The effects of different interventions were compared between the two groups.A 2-year follow-up was conducted to analyze the general data of patients with good prognosis and poor prognosis according to the recovery of hand function,and logistic regression analysis was performed to analyze the risk factors affecting the recovery of hand function.Result:Compared with group B,TAM activity group A were significantly higher.VAS score was lower(P<0.05),SF-36 score was higher(P<0.05);The AO type was C,the presence of other ipsilateral fractures and the unsatisfactory evaluation of intraoperative fracture reduction were the influencing factors(P<0.05).Conclusion:For patients with hand fractures,limited internal fixation combined with micro external fixation has a higher therapeutic effect.Meanwhile,AO classification,other fractures on the same side,and intraoperative fracture reduction evaluation are all factors affecting the long-term prognosis of hand function.

关 键 词：手部骨折 有限内固定结合微型外固定架治疗 远期预后 固定方法 临床价值 

分 类 号：R687.3[医药卫生—骨科学]