改良式外固定法治疗多发跖趾骨头骨折的临床研究
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摘要
目的:观察改良式外固定法对多发跖趾骨头骨折的临床疗效。方法:选择2016年1月~2017年1月至我院进行多发性跖趾骨头骨折患者84例进行临床研究。根据来诊时间排序。序列号为单号患者作为观察组,序列号为双号患者作为对照组,各42例,对照组患者给予传统克氏针内固定法进行治疗。观察组患者给予改良式外固定法治疗。观察两组患者术后足部功能恢复情况以及两组患者骨折愈合时间及并发症发生情况。结果:观察组患者优良率为95.24%,明显高于对照组76.19%,且具有统计学差异;观察组患者愈合平均(7.92±1.33)周,明显短于对照组(8.76±1.09)周,且具有统计学差异,观察组并发症发生3例,占7.14%,明显低于对照组11例,26.19%,且具有统计学差异。结论:改良式外固定法对多发跖趾骨头骨折具有良好的临床疗效,能够明显改善患者足部功能的预后,缩短骨折的愈合时间,并且能够降低并发症的发生率,安全性好,具有广阔的临床应用前景和良好的应用价值。
Objective To observe the clinical effect of modified external fixation in the treatment of multiple metatarsal head fractures. Methods A total of 84 patients with multiple metatarsal head fractures in our hospital from January 2016~2017 to January were selected for clinical study. According to the time of diagnosis. The serial number is odd number patients as the observation group, the serial number is the number of patients as the control group, 42 cases in each group, the control group patients were treated with traditional Kirschner wire internal fixation. Patients in the observation group were treated with modified external fixation. The functional recovery of the two groups of patients after surgery and the fracture healing time and complications of the two groups were observed. Results The patients in the observation group the excellent rate was 95.24% and 76.19% higher than the control group, and the difference was statistically significant; the average healing of patients in the observation group(7.92± 1.33) weeks, significantly shorter than the control group(8.76 ± 1.09) weeks, and has a statistically significant difference, the incidence of complications was observed in 3 cases, accounting for 7.14%, significantly lower than the control group in 11 cases, 26.19%, with a significant difference. Conclusion The modified external fixation has good clinical efficacy in the treatment of multiple metatarsal fractures, can significantly improve the prognosis of patients with foot function, shorten the healing time of fracture, and can reduce the incidence of complications, good safety, it has broad prospects of clinical application and good application value.
Objective To observe the clinical effect of modified external fixation in the treatment of multiple metatarsal head fractures. Methods A total of 84 patients with multiple metatarsal head fractures in our hospital from January 2016~2017 to January were selected for clinical study. According to the time of diagnosis. The serial number is odd number patients as the observation group, the serial number is the number of patients as the control group, 42 cases in each group, the control group patients were treated with traditional Kirschner wire internal fixation. Patients in the observation group were treated with modified external fixation. The functional recovery of the two groups of patients after surgery and the fracture healing time and complications of the two groups were observed. Results The patients in the observation group the excellent rate was 95.24% and 76.19% higher than the control group, and the difference was statistically significant; the average healing of patients in the observation group(7.92± 1.33) weeks, significantly shorter than the control group(8.76 ± 1.09) weeks, and has a statistically significant difference, the incidence of complications was observed in 3 cases, accounting for 7.14%, significantly lower than the control group in 11 cases, 26.19%, with a significant difference. Conclusion The modified external fixation has good clinical efficacy in the treatment of multiple metatarsal fractures, can significantly improve the prognosis of patients with foot function, shorten the healing time of fracture, and can reduce the incidence of complications, good safety, it has broad prospects of clinical application and good application value.
引文
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[10]苏建才,景文清,薛育芳.微创经皮克氏针固定治疗新鲜跖骨骨折[J].实用医技杂志,2015(8):874-875.
[11]梁礼汗,高峻青,陈卫婷,等.可吸收棒联合可吸收线捆绑内固定治疗不稳定型跖骨骨折[J].中国综合临床,2015,31(6):564-567.
[12]林伟文,赖茂松,熊浩,等.可吸收钉棒治疗儿童桡骨远端不稳定型骨折的疗效观察[J].中华创伤骨科杂志,2015,17(7):632-634.
[13]王远辉,万永鲜,叶里子,等.克氏针及可吸收棒内固定修复儿童肱骨髁上骨折:生物相容性比较[J].中国组织工程研究,2015(26):4218-4222.
[14]蔡汉周.PDLLA可吸收材料和克氏针内固定治疗掌骨骨折疗效比较[J].中国临床实用医学,2010,04(1):102-103.
[15]Kornmayer M,Failing K,Matis U.Long-term prognosis of metacarpal and metatarsal fractures in dogs.A retrospective analysis of medical histories in 100 re-evaluated patients[J].Vet Comp Orthop Traumatol,2014,27(1):45-53.
[2]Benlloch G M,Grapperon M M,Bouvy B.Computed tomography assisted determination of optimal insertion points and bone corridors for transverse implant placement in the feline tarsus and metatarsus[J].Vet Comp Orthop Traumatol,2014,27(6):441-446.
[3]Doganavsargil B,Argin M,Sezak M,et al.A bizarre parosteal osteochondromatous proliferation(Nora's lesion)of metatarsus,a histopathological and etiological puzzlement[J].Joint Bone Spine,2014,81(6):537-540.
[4]任科伟,韦山,姜雪峰,等.改良跟骨钢板治疗跟骨关节内骨折的临床效果观察[J].上海交通大学学报(医学版)2016,36(12)1768-1771.
[5]向成浩,陈文革,蒋从斌,等.可吸收棒治疗MasonⅡ、Ⅲ型桡骨小头骨折临床疗效分析[J].生物骨科材料与临床研究,2015,12(5):27-30.
[6]魏亦兵,王思群,夏军,等.跖骨骨折的手术治疗[J].中华创伤骨科杂志,2005,7(6):526-528.
[7]孙建筑,王向华,陆明瑶,等.早期切开复位无头加压空心螺钉及克氏针治疗经舟骨月骨周围脱位的临床研究[J].湖南师范大学学报(医学版),2016,13(2):126-128.
[8]赵晓明,黄金秀.微型钢板内固定治疗多发跖骨骨折22例体会[J].河南外科学杂志,2015,21(4):46-47.
[9]孙建筑,苏立东,陆明瑶,等.无头加压空心螺钉在桡骨远端骨折内固定术中的应用效果[J].湖南师范大学学报(医学版),2017,14(1):179-182.
[10]苏建才,景文清,薛育芳.微创经皮克氏针固定治疗新鲜跖骨骨折[J].实用医技杂志,2015(8):874-875.
[11]梁礼汗,高峻青,陈卫婷,等.可吸收棒联合可吸收线捆绑内固定治疗不稳定型跖骨骨折[J].中国综合临床,2015,31(6):564-567.
[12]林伟文,赖茂松,熊浩,等.可吸收钉棒治疗儿童桡骨远端不稳定型骨折的疗效观察[J].中华创伤骨科杂志,2015,17(7):632-634.
[13]王远辉,万永鲜,叶里子,等.克氏针及可吸收棒内固定修复儿童肱骨髁上骨折:生物相容性比较[J].中国组织工程研究,2015(26):4218-4222.
[14]蔡汉周.PDLLA可吸收材料和克氏针内固定治疗掌骨骨折疗效比较[J].中国临床实用医学,2010,04(1):102-103.
[15]Kornmayer M,Failing K,Matis U.Long-term prognosis of metacarpal and metatarsal fractures in dogs.A retrospective analysis of medical histories in 100 re-evaluated patients[J].Vet Comp Orthop Traumatol,2014,27(1):45-53.