微型钢板对闭合性掌骨骨折愈合及术后手功能恢复的影响
|
摘要
目的探求闭合性掌骨骨折患者采用微型钢板内固定治疗对其骨折愈合及术后手功能恢复的影响。方法对2016年4月-2017年8月收治的闭合性掌骨骨折98例,按单盲法分为对照组和观察组,每组各49例。对照组采用克氏针内固定治疗,观察组采用微型钢板内固定治疗,术后随访6～12个月,比较两组手术情况、手功能及并发症的发生情况。结果对照组住院时间(7.14±1.35) d、骨折愈合时间(8.92±2.41)周,均长于观察组(4.85±1.22) d、(6.37±1.58)周,差异具有统计学意义(P<0.05);对照组手功能恢复总优良率为79.59%,低于观察组的93.88%,差异具有统计学意义(P<0.05);对照组并发症总发生率为16.33%,高于观察组的4.08%,差异具有统计学意义(P<0.05);对照组术中失血量(18.52±4.25) mL、手术时间(46.38±6.22) min与观察组(20.18±4.30) mL、(44.98±6.57) min相比,差异无统计学意义(P>0.05)。结论闭合性掌骨骨折采用微型钢板内固定治疗可缩短骨折愈合时间,降低并发症发生率,促进手功能恢复。
Objective To investigate the effect of mini-plate internal fixation on fracture healing and postoperative recovery of hand function in patients with closed fracture of metacarpal bone. Methods Ninty eight patients with closed fracture of metacarpal bone admitted in the hospital from April 2016 to August 2017 were selected, and they were divided into control group and experimental group by single blind method, with 49 cases in each group. Control group was given Kirschner wire internal fixation,while experimental group was treated with mini-plate internal fixation, and they were given postoperative follow-up for 6 ～12 months. The surgical conditions, hand function, complications were compared between the two groups. Results The hospital stay and fracture healing time of control group(7.14±1.35) d,(8.92±2.41) weeks were longer than experimental group(4.85±1.22) d,(6.37±1.58) weeks(P <0.05); the total excellent rate of hand function recovery in control group(79.59%) was lower than experimental group(93.88%)(P<0.05); the total incidence of complications in control group(16.33%) was higher than experimental group(4.08%)(P<0.05); there was no statistical difference in the intraoperative bleeding volume and operation time between control group(18.52 ±4.25) mL,(46.38 ±6.22) min and experimental group(20.18±4.30) mL,(44.98±6.57) min(P>0.05). Conclusion Mini-plate internal fixation in treatment of closed fracture of metacarpal bone can shorten fracture healing time, decrease the incidence of complications, and promote recovery of hand function.
Objective To investigate the effect of mini-plate internal fixation on fracture healing and postoperative recovery of hand function in patients with closed fracture of metacarpal bone. Methods Ninty eight patients with closed fracture of metacarpal bone admitted in the hospital from April 2016 to August 2017 were selected, and they were divided into control group and experimental group by single blind method, with 49 cases in each group. Control group was given Kirschner wire internal fixation,while experimental group was treated with mini-plate internal fixation, and they were given postoperative follow-up for 6 ～12 months. The surgical conditions, hand function, complications were compared between the two groups. Results The hospital stay and fracture healing time of control group(7.14±1.35) d,(8.92±2.41) weeks were longer than experimental group(4.85±1.22) d,(6.37±1.58) weeks(P <0.05); the total excellent rate of hand function recovery in control group(79.59%) was lower than experimental group(93.88%)(P<0.05); the total incidence of complications in control group(16.33%) was higher than experimental group(4.08%)(P<0.05); there was no statistical difference in the intraoperative bleeding volume and operation time between control group(18.52 ±4.25) mL,(46.38 ±6.22) min and experimental group(20.18±4.30) mL,(44.98±6.57) min(P>0.05). Conclusion Mini-plate internal fixation in treatment of closed fracture of metacarpal bone can shorten fracture healing time, decrease the incidence of complications, and promote recovery of hand function.
引文
[1]张睿,信维伟.交叉克氏针与微型钢板治疗闭合性掌骨骨折效果对比[J].实用骨科杂志,2017,23(10):927-929.
[2]胡宏伟,卓树涛,潘银华.弹性髓内针和微型钢板治疗A型掌骨骨折疗效的对比分析[J].中国矫形外科杂志,2015,23(8):759-761.
[3]周小祥,刘立春,沈旭江,等.TiNi形状记忆合金环抱器与微型钢板内固定治疗掌骨骨折的效果比较[J].浙江医学,2016,38(8):575-576.
[4]马乾鹏,童锋,马建平,等.微型钢板治疗多发掌骨骨折107例临床体会[J].宁夏医科大学学报,2015,37(12):1470-1472.
[5]陈智,陈歌,尹一然.微型钢板与克氏针内固定治疗掌指骨骨折的Meta分析[J].重庆医学,2016,45(29):4095-4098.
[6]Khan A,Giddins G.The outcome of conservative treatment of spiral metacarpal fractures and the role of the deep transverse metacarpal ligaments in stabilizing these injuries[J].Journal of Hand Surgery European Volume,2015,40(1):59-62.
[7]罗洪斌.微型钢板置入内固定修复掌骨复杂骨折:优于克氏针的理由[J].中国组织工程研究,2015,19(35):5691-5696.
[8]刘卫峰,陶峰琴,王忠祥,等.微型钢板与克氏针内固定治疗掌骨颈骨折的疗效分析[J].局解手术学杂志,2017,26(10):724-727.
[9]朱勇,朱永林,罗显德,等.克氏针和微型钢板内固定治疗不同节段掌指骨骨折疗效比较[J].医学临床研究,2015,32(7):1370-1372.
[10]Pace GI,Gendelberg D,Taylor KF.The Effect of Closed Reduction of Small Finger Metacarpal Neck Fractures on the Ultimate Angular Deformity[J].Journal of Hand Surgery,2015,40(8):1582-1585.
[11]夏晓明.克氏针与微型钢板置入内固定修复掌指骨骨折:手部功能及不良反应随访[J].中国组织工程研究,2015,19(17):2741-2744.
[12]丁玉勤.手部骨折患者实施微型钢板治疗对其手功能康复状况及愈合时间的影响分析[J].临床和实验医学杂志,2015,14(21):1816-1818.
[13]杨海洲,顾家平,许勇.微型钢板内固定治疗掌指骨骨折[J].实用手外科杂志,2017,31(2):196-197,201.
[14]游朝勇,陆大鹏,徐雪平.微型钢板与克氏针内固定治疗拳击手骨折疗效对比[J].实用手外科杂志,2017,31(3):330-331.
[2]胡宏伟,卓树涛,潘银华.弹性髓内针和微型钢板治疗A型掌骨骨折疗效的对比分析[J].中国矫形外科杂志,2015,23(8):759-761.
[3]周小祥,刘立春,沈旭江,等.TiNi形状记忆合金环抱器与微型钢板内固定治疗掌骨骨折的效果比较[J].浙江医学,2016,38(8):575-576.
[4]马乾鹏,童锋,马建平,等.微型钢板治疗多发掌骨骨折107例临床体会[J].宁夏医科大学学报,2015,37(12):1470-1472.
[5]陈智,陈歌,尹一然.微型钢板与克氏针内固定治疗掌指骨骨折的Meta分析[J].重庆医学,2016,45(29):4095-4098.
[6]Khan A,Giddins G.The outcome of conservative treatment of spiral metacarpal fractures and the role of the deep transverse metacarpal ligaments in stabilizing these injuries[J].Journal of Hand Surgery European Volume,2015,40(1):59-62.
[7]罗洪斌.微型钢板置入内固定修复掌骨复杂骨折:优于克氏针的理由[J].中国组织工程研究,2015,19(35):5691-5696.
[8]刘卫峰,陶峰琴,王忠祥,等.微型钢板与克氏针内固定治疗掌骨颈骨折的疗效分析[J].局解手术学杂志,2017,26(10):724-727.
[9]朱勇,朱永林,罗显德,等.克氏针和微型钢板内固定治疗不同节段掌指骨骨折疗效比较[J].医学临床研究,2015,32(7):1370-1372.
[10]Pace GI,Gendelberg D,Taylor KF.The Effect of Closed Reduction of Small Finger Metacarpal Neck Fractures on the Ultimate Angular Deformity[J].Journal of Hand Surgery,2015,40(8):1582-1585.
[11]夏晓明.克氏针与微型钢板置入内固定修复掌指骨骨折:手部功能及不良反应随访[J].中国组织工程研究,2015,19(17):2741-2744.
[12]丁玉勤.手部骨折患者实施微型钢板治疗对其手功能康复状况及愈合时间的影响分析[J].临床和实验医学杂志,2015,14(21):1816-1818.
[13]杨海洲,顾家平,许勇.微型钢板内固定治疗掌指骨骨折[J].实用手外科杂志,2017,31(2):196-197,201.
[14]游朝勇,陆大鹏,徐雪平.微型钢板与克氏针内固定治疗拳击手骨折疗效对比[J].实用手外科杂志,2017,31(3):330-331.