自制外固定架治疗多发跖趾骨头骨折的临床研究
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摘要
目的观察自制外固定架治疗多发跖趾骨头骨折的临床效果。方法选取多发跖趾骨头骨折患者150例,随机分为外固定组(自制外固定架固定)和内固定组(常规切开复位内固定)各75例。比较2组手术疗效、足趾畸形和残端修整率以及术后并发症发生情况。结果所有患者均顺利完成手术,随访3~12个月。外固定组住院和骨折愈合时间明显短于内固定组,治疗费用低于内固定组,差异均有统计学意义(P<0.05)。2组手术时间差异无统计学意义(P>0.05)。外固定组临床疗效优于内固定组,优良率明显高于内固定组,畸形和残端修整率明显低于内固定组,差异均有统计学意义(P<0.05)。外固定组术后并发症发生率明显低于内固定组,差异有统计学意义(P<0.05)。结论自制外固定架治疗多发跖趾骨头骨折效果显著且安全性好。
Objective To investigate the clinical effect of homemade external fixator in the treatment of multiple metatarsal and phalangeal head fractures.Methods A total of 150 cases patient with multiple metatarsal and phalangeal head fractures were selected.They were divided randomly into external fixation group(homemade external fixator fixation)and internal fixation group(conventional open reduction and internal fixation),each with 75 cases.The surgical effect,toe deformity,stump trimming rates and postoperative complications were compared.Results All the patients underwent the operation successfully,and were followed up for 3-12 months.The time of hospitalization and fracture healing in the external fixation group was significantly shorter than that in the internal fixation group,and the cost of treatment was lower than that in the internal fixation group.The difference was statistically significant(P<0.05).There were no significant statistical differences in operation time(P>0.05).The clinical efficacy for the external fixation group is superior to the internal fixation group,with significantly higher good rate and lower deformity and stump trimming rates.The differences were statistically significant(P< 0.05). The postoperative complications in the external fixation group is significantly lower than that in the internal fixation group,and the difference was statistically significant(P<0.05).Conclusion Homemade external fixator has significant effect and higher safety in the treatment of multiple metatarsal and phalangeal head fractures.
Objective To investigate the clinical effect of homemade external fixator in the treatment of multiple metatarsal and phalangeal head fractures.Methods A total of 150 cases patient with multiple metatarsal and phalangeal head fractures were selected.They were divided randomly into external fixation group(homemade external fixator fixation)and internal fixation group(conventional open reduction and internal fixation),each with 75 cases.The surgical effect,toe deformity,stump trimming rates and postoperative complications were compared.Results All the patients underwent the operation successfully,and were followed up for 3-12 months.The time of hospitalization and fracture healing in the external fixation group was significantly shorter than that in the internal fixation group,and the cost of treatment was lower than that in the internal fixation group.The difference was statistically significant(P<0.05).There were no significant statistical differences in operation time(P>0.05).The clinical efficacy for the external fixation group is superior to the internal fixation group,with significantly higher good rate and lower deformity and stump trimming rates.The differences were statistically significant(P< 0.05). The postoperative complications in the external fixation group is significantly lower than that in the internal fixation group,and the difference was statistically significant(P<0.05).Conclusion Homemade external fixator has significant effect and higher safety in the treatment of multiple metatarsal and phalangeal head fractures.
引文
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[11]刘增兵,贾杰,武志辉,等.自制克氏针外固定架结合掌背动脉岛状皮瓣治疗慢性指骨骨髓炎[J].中国骨与关节损伤杂志,2014,29(11):1174-1175.
[12]项杰,陈肖肖,蔡国平,等.克氏针外固定牵引架在治疗近节指间关节骨折脱位中的应用[J].医学研究杂志,2015,44(7):132-135.
[13]高洪宽,高俊峰,吴丽艳,等.自制克氏针外固定架治疗指骨开放骨折31例[J].中国骨与关节损伤杂志,2014,29(11):1177-1178.
[14]高俊峰,高洪宽,张超.克氏针自制外固定架治疗指骨粉碎性骨折的疗效分析[J].中国骨与关节损伤杂志,2015,30(6):79.
[15]刘广跃,梁虎.手足多发性痛风结节误诊腱鞘巨细胞瘤1例[J].河北医科大学学报,2014,35(10):1187,1200.
[16]王华柱,杜志国,陈广先,等.克氏针固定橡皮筋牵引治疗陈旧性近侧指间关节骨折脱位[J].中华骨科杂志,2012,32(7):669-674.
[17]王保宁,周彦青,杨双贵,等.微创钢板辅助加压螺钉对跟骨关节内骨折患者术后恢复效果及并发症的影响[J].河北医科大学学报,2017,38(7):832-834.
[2]卢泽明,林新晓,程灏,等.外固定治疗第五跖骨基底Ⅰ区骨折36例[J].中国中西医结合外科杂志,2014,20(4):437-438.
[3]何恩荣,杨小华.两种内固定方法治疗跖骨骨折的疗效比较[J].生物骨科材料与临床研究,2015,12(3):75-76.
[4]朱勇,朱永林,罗显德.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.
[5]Van Lieshout EM,De Boer AS,Meuffels DE,et al.American Orthopaedic Foot and Ankle Society(AOFAS)AnkleHindfoot Score:a study protocol for the translation and validation of the Dutch language version[J].BMJ Open,2017,7(2):e012884.
[6]Xing SG,Tang JB.Surgical treatment,hardware removal,and the wide-awake approach for metacarpal fractures[J].Clin Plast Surg,2014,41(3):463-480.
[7]孙卫东,李晏乐,温建民,等.基于X线分度的跖痛症临床治疗方案研究[J].中国骨与关节损伤杂志,2017,32(2):168-171.
[8]石昆,李景毅.有限切开微型钢板与克氏针内固定治疗掌骨骨折的对比研究[J].生物医学工程与临床,2015,19(2):149-152.
[9]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):4095-4098,4102.
[10]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.
[11]刘增兵,贾杰,武志辉,等.自制克氏针外固定架结合掌背动脉岛状皮瓣治疗慢性指骨骨髓炎[J].中国骨与关节损伤杂志,2014,29(11):1174-1175.
[12]项杰,陈肖肖,蔡国平,等.克氏针外固定牵引架在治疗近节指间关节骨折脱位中的应用[J].医学研究杂志,2015,44(7):132-135.
[13]高洪宽,高俊峰,吴丽艳,等.自制克氏针外固定架治疗指骨开放骨折31例[J].中国骨与关节损伤杂志,2014,29(11):1177-1178.
[14]高俊峰,高洪宽,张超.克氏针自制外固定架治疗指骨粉碎性骨折的疗效分析[J].中国骨与关节损伤杂志,2015,30(6):79.
[15]刘广跃,梁虎.手足多发性痛风结节误诊腱鞘巨细胞瘤1例[J].河北医科大学学报,2014,35(10):1187,1200.
[16]王华柱,杜志国,陈广先,等.克氏针固定橡皮筋牵引治疗陈旧性近侧指间关节骨折脱位[J].中华骨科杂志,2012,32(7):669-674.
[17]王保宁,周彦青,杨双贵,等.微创钢板辅助加压螺钉对跟骨关节内骨折患者术后恢复效果及并发症的影响[J].河北医科大学学报,2017,38(7):832-834.