纵行与斜行空心拉力螺钉内固定治疗近节指骨横行骨折的疗效分析  

Clinical efficacy of vertical and oblique hollow tension screw internal fixation in patients with proximal phalangeal transverse fractures

作　　者：袁明阳 赵庆国 殷钰涵 YUAN Mingyang;ZHAO Qingguo;YIN Yuhan(Department of Emergency(Trauma surgery),the Affiliated Hospital of Jiangnan University,Wuxi,Jiangsu 214122,China)

机构地区：[1]江南大学附属医院急诊(创伤外科),江苏无锡214122

出　　处：《临床外科杂志》2024年第10期1074-1077,共4页Journal of Clinical Surgery

摘　　要：目的探讨纵行与斜行空心拉力螺钉内固定对近节指骨横行骨折病人指间、掌关节活动度及并发症的影响。方法2021年6月~2022年2月收治的近节指骨横行骨折病人102例,根据治疗方法将其分为纵行组与斜行组,纵行组给予纵行空心拉力螺钉内固定治疗,斜行组给予斜行空心拉力螺钉内固定治疗,将纳入研究对象基线资料根据倾向性匹配评分法(卡钳值为0.02)排除混杂因素影响,两组各获得51例(纵行组51根、斜行组51根)基线资料可比的病人。比较两组病人手术时间、骨折愈合时间、术后18个月后指间与掌关节活动度、手关节功能优良率(TAM)及并发症情况。结果所有病人均顺利完成手术,均获得至少18个月随访数据,两组病人手术时间、随访时间比较差异无统计学意义(P>0.05),斜行组骨折愈合时间为(6.57±1.22)周,纵行组为(7.82±1.54)周,两组比较差异有统计学意义(P<0.05);术后18个月,斜行组指间活动度为(82.62±3.41)°,纵行组为(77.45±7.46)°,两组比较差异有统计学意义(P<0.05),两组掌关节活动度比较差异无统计学意义(P>0.05);术后18个月,斜行组病人手功能优良率(94.12%)显著高于纵行组(80.39%),两组比较差异有统计学意义(P<0.05);两组并发症发生率比较差异无统计学意义(P>0.05)。结论近节指骨横行骨折病人行空心拉力螺钉内固定治疗,采用纵行与斜行置钉法均有较好效果,但斜行置钉法更利于病人手功能恢复,可根据病人实际情况适当应用。Objective To explore the influence of longitudinal and oblique hollow lag screw internal fixation on interphalangeal range of motion,metacarpal range of motion and complications in patients with transverse fractures of proximal phalanges.Methods Retrospective analysis was performed on 102 patients with transverse fractures of proximal phalanges admitted to department of orthopedics of our hospital from June 2021 to February 2022.According to treatment methods,the patients were divided into longitudinal group and oblique group.The longitudinal group was given longitudinal hollow lag screw internal fixation while the oblique group was treated with oblique hollow lag screw internal fixation.The baseline data of the enrolled subjects were excluded from the influence of confounding factors according to the propensity matching scoring method(caliper value=0.02),and 51 patients with comparable baseline data were obtained in each group.The surgical status(surgical time and healing time),ranges of motions of interphalangeal and metacarpal joints,excellent and good rate of hand function(total active movement,TAM)and complications at 18 months after surgery were compared between the two groups.Results All patients successfully completed the surgery,and at least 18 months of follow-up data were obtained.There was no statistical significance in the surgical time or follow-up time between the two groups(P>0.05).The healing time in oblique group(6.57±1.22)weeks,was significantly shorter than that in longitudinal group(7.82±1.54)weeks(P<0.05).At 18 months after surgery,the interphalangeal range of motion was significantly higher in oblique group(82.62±3.41)°than that in longitudinal group(77.45±7.46)°(P<0.05),but there was no statistical difference in metacarpal range of motion between the two groups(P>0.05).The excellent and good rate of hand function in oblique group(94.12%)at 18 months after surgery was significantly higher than that in longitudinal group(80.39%)(P<0.05).The incidence of complications revealed no statis

关 键 词：空心拉力螺钉内固定 近节指骨横行骨折 关节活动度 

分 类 号：R687.3[医药卫生—骨科学]