不同入路微型钢板内固定治疗指骨骨折疗效对比  

Comparison of Clinical Efficacy of Mini⁃plate Internal Fixation in Different Approaches for the Treatment of Phalangeal Fractures

作　　者：黎成成 殷子敬 区钰强 LI Chengcheng;YIN Zijing;OU Yuqiang(DepartmentⅢof Orthopedics,Zhaoqing Hospital of Traditional Chinese Medicine,Zhaoqing,Guangdong 526000,China)

机构地区：[1]肇庆市中医院骨三科,广东肇庆526000

出　　处：《中国烧伤创疡杂志》2024年第4期283-287,共5页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的对比分析不同入路微型钢板内固定治疗指骨骨折的临床疗效。方法选取2020年1月至2022年1月肇庆市中医院收治的92例指骨骨折患者作为研究对象,按照不同手术入路方式将其分为侧方入路组(46例)和背侧入路组(46例),侧方入路组患者采用侧方入路微型钢板内固定治疗,背侧入路组患者采用背侧入路微型钢板内固定治疗,对比观察两组患者手术相关指标、骨折愈合时间、疼痛程度、患侧手握力、患指关节功能恢复情况以及不良事件发生情况。结果侧方入路组患者手术时间及术中出血量与背侧入路组无明显差异(t=0.839、1.909,P=0.404、0.059),患指骨折愈合时间明显短于背侧入路组(t=6.516,P<0.001)。术后1、3个月,侧方入路组患者患指视觉模拟评分法(VAS)评分均明显低于背侧入路组(t=3.032、1.998,P=0.003、0.049),患侧手握力均明显大于背侧入路组(t=5.095、2.220,P<0.001、P=0.029)。术后3个月,侧方入路组患者患指关节功能恢复优良率为93.48%,明显高于背侧入路组患者的患指关节功能恢复优良率78.26%(χ^(2)=4.389,P=0.036)。侧方入路组患者术后不良事件发生率为8.70%,明显低于背侧入路组患者的术后不良事件发生率26.09%(χ^(2)=4.842,P=0.028)。结论与背侧入路微型钢板内固定相比,侧方入路微型钢板内固定更能有效缓解指骨骨折患者的疼痛程度,提高患侧手握力及患指关节功能恢复效果,降低术后不良事件发生率。Objective To compare the clinical efficacy of mini-plate internal fixation in different approaches in treating phalangeal fractures.Methods 92 patients with phalangeal fractures admitted to Zhaoqing Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were enrolled as the research subjects,and divided into the lateral approach group(n=46),receiving the mini-plate internal fixation in the lateral approach and the dorsal approach group(n=46),receiving the mini-plate internal fixation in the dorsal approach.The surgery-related indexes,fracture healing time,pain degree,grip strength of the affected hand,joint function recovery,and occurrence of adverse reactions were compared between the two groups.Results The operation time and intraoperative blood loss of patients in the lateral approach group were not significantly different from those in the dorsal approach group(t=0839 and 1909,P=0404 and 0059).The fracture healing time of the affected finger in the lateral approach group was significantly shorter than that in the dorsal approach group(t=6516,P<0001).Respectively on month 1 and 3 after surgery,the visual analogue scale(VAS)scores of the affected finger of patients in the lateral approach group were significantly lower than those in the dorsal approach group(t=3032 and 1998,P=0003 and 0049),and grip strength of the affected hand was significantly greater in the lateral approach group(t=5095 and 2220,P<0001,P=0029).On month 3 after surgery,the good and excellent rate of functional recovery of the affected finger joints was 9348%in the lateral approach group,which was signif-icantly higher than the corresponding 7826%in the dorsal approach group(χ^(2)=4389,P=0036).The incidence of post-operative adverse reactions in patients in the lateral approach group was 870%,much lower than 2609%in the dorsal approach group(χ^(2)=4842,P=0028).Conclusion Compared with dorsal approach mini-plate internal fixation,lateral approach mini-plate internal fixation can more effectively relieve the pain degree of

关 键 词：侧方入路 背侧入路 微型钢板内固定 指骨骨折 骨折愈合 

分 类 号：R687.3[医药卫生—骨科学]