切开复位微型T型髁钢板固定和闭合复位微型外固定支架固定治疗第2~5掌骨颈骨折的效果对比  

Comparison of the Effects of Open Reduction with Mini T-shaped Condylar Plate Fixation and Closed Reduction with Mini External Fixator Fixation for the Treatment of 2nd to 5th Metacarpal Neck Fractures

作　　者：张宽宽 韩仲兵 牛海州 刘洋洋 ZHANG Kuankuan;HAN Zhongbing;NIU Haizhou;LIU Yangyang(The First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China;不详)

机构地区：[1]蚌埠医学院第一附属医院,安徽蚌埠233004

出　　处：《中外医学研究》2023年第34期23-27,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:对比切开复位微型T型髁钢板固定和闭合复位微型外固定支架固定治疗第2~5掌骨颈骨折的效果。方法:选取2020年1月—2022年12月蚌埠医学院第一附属医院收治的60例第2~5掌骨颈骨折患者,按照随机数表法分为两组,各30例。A组采用切开复位微型T型髁钢板固定,B组采用闭合复位微型外固定支架固定,观察两组手术相关情况、手指关节功能状态、疼痛介质及并发症发生率。结果:B组手术时间短于A组,术中出血量少于A组,差异有统计学意义(P<0.05)。随访6个月后,B组手指关节功能总优良率、握力均高于A组,差异有统计学意义(P<0.05)。术前,两组5-羟色胺(5-HT)、神经肽Y(NPY)比较,差异无统计学意义(P>0.05);术后24 h,两组5-HT、NPY均高于术前,差异有统计学意义(P<0.05),但两组间比较,差异无统计学意义(P>0.05)。两组各项并发症发生率比较,差异无统计学意义(P>0.05)。结论:切开复位微型T型髁钢板固定和闭合复位微型外固定支架固定在疼痛介质水平、并发症方面相当,但相较而言,闭合复位微型外固定手术效果更好,手指关节功能恢复更优。Objective:To compare the effect of open reduction with mini T-shaped condylar plate fixation and closed reduction with mini external fixator fixation in the treatment of 2nd to 5th metacarpal neck fracture.Method:A total of 60 patients with 2nd to 5th metacarpal neck fracture admitted to the First Affiliated Hospital of Bengbu Medical College from January 2020 to December 2022 were selected and divided into two groups according to random number table method,with 30 cases in each group.Group A was fixed with open reduction with mini T-shaped condylar plate fixation,and group B was fixed with closed reduction with mini external fixator fixation.The operative conditions,functional status of finger joint,pain medium and complication rate of the two groups were observed.Result:The operation time of group B was shorter than that of group A,and the intraoperative blood loss was less than that of group A,the differences were statistically significant(P<0.05).After 6 months of follow-up,the total excellent and good rate of finger joint function and grip strength in group B were higher than those in group A,and the differences were statistically significant(P<0.05).Before operation,there were no significant differences in 5-hydroxytryptamine(5-HT)and neuropeptide Y(NPY)between the two groups(P>0.05).At 24 h after operation,5-HT and NPY in both groups were higher than those before operation,and the differences were statistically significant(P<0.05),but there were no statistical significances between the two groups(P>0.05).There were no significant differences in the incidence of complications between the two groups(P>0.05).Conclusion:Open reduction with mini T-shaped condylar plate fixation and closed reduction with mini external fixator fixation is similar influence the pain media levels and complications.However,the effect of closed reduction and micro external fixation is better,and the functional recovery of finger joint is better.

关 键 词：切开复位微型T型髁钢板固定 闭合复位微型外固定支架固定 第2~5掌骨颈骨折 手指关节功能 

分 类 号：R687.3[医药卫生—骨科学]