| 克氏针与微型钢板内固定治疗掌指骨骨折的比较 |
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投稿时间：2003-03-22
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| 期刊信息：《中国骨伤》2004年，第17卷，第2期，第68-70页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的:比较微型钢板与克氏针内固定治疗手部骨折的疗效及并发症。
方法:随机选择病例,应用长1.5～2.5cm,宽0.4cm的微型钢板(T形、L形、直形钢板)对50例(55处)掌指骨骨折进行内固定治疗。闭合伤40例处,开放伤15例处,其中加用丝线捆扎7例,Ⅰ期植骨3例,术后尽早进行功能锻炼(平均5d),并与同期行克氏针内固定的41例(45处)掌指骨骨折病例进行比较。
结果:钢板组47例处获得随访,平均1.4年,骨折平均愈合(3.2±1.2)个月,发生浅表感染8例处,延迟愈合3例处,局部因钢板引起不适或疼痛15例处,早期伸肌黏连6例处,并发症发生是与开放损伤或软组织损伤程度、关节内骨折或邻关节骨折相关,全组功能恢复优良率为89%。克氏针组45例处均获得随访,平均12年,骨折平均愈合(38±11)个月,发生伤口浅表感染7例处,针道感染3例处,关节僵硬3例处,延迟愈合4例处,畸形愈合2例处,不愈合1例处,因克氏针原因引起不适20例处,全组功能恢复优良率为73%。 |
| 【关键词】掌骨骨折 指骨骨折 骨折固定术,内 |
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| Comparison of metacarpal and phalangeal fracture with microplate and Kirschner wire |
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ABSTRACT
Objective:To compare the effect and complication of microplate and Kirschner wire fixation for metacarpal and phalangeal fracture.
Methods:A prospective study of 50 patients with 55 metacarpal and phalangeal fracture were treated with microplate(length 1.5～2.5 cm,wide 0.4 cm,T-shape,L-shape,straight-shape).Close fracture were 40 cases and open fracture 15 cases.Of these were addition used wire bending in 7 cases and bone-grafting in 3 cases.All patients started exercise immediately after operation(average 5 days).These patients were compared with 41 cases with Kirschner wire fixation in same period.
Results:In metacarpal fixation group,47 cases were followed-up for an average of 1.4 years.All fractures healed at an average (3.2±1.2)months.The complication included superficial infection in 8 cases,delay union in 3 cases,patient feel uncomfortable or pain because of microplate in 15 cases,early extensor lag in 6 cases.The cause of complication was related with open injury or soft-tissue injury degree,intra-articular or periarticular fracture.The effect was evaluated according to the criteria of Ouellette.The rate of excellent and good was 89%.In Kirschner wire fixation group,45 cases were followed-up for an average of 1.2 years.All fractures healed at an average (3.8±1.1)months.The complication included superficial infection in 7 cases,nail tract infection in 3 cases,joint stiff in 3 cases,delay union in 4 cases,malunion in 2 cases,nonunion in 1 cases,patient feel uncomfortable because of Kirschner wire in 20 cases.The rate of excellent and good was 73%.There is significant difference in rate of excellent and good(χ 2=3.908,P<0.05),average fractures heal time(t=2.496,P<0.05)between two groups.No differences between groups were found by total complication and there is only significant difference in infection,fracture healing,joint stiff(χ 2=4.562,P<0.05).
Conclusion:Microplate fixation is a good internal fixation for treatment of fractures of the metacarpal and phalangeal fracture. |
| KEY WORDS Metacarpal fracture Phalangeal fracture Fracture fixation,internal |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 唐三元,杨辉,付海鹰,向明.克氏针与微型钢板内固定治疗掌指骨骨折的比较[J].中国骨伤,2004,17(2):68~70 |
| 英文格式: | TANG San-yuan,YANG Hui,FU Hai-ying,XIANG Ming.Comparison of metacarpal and phalangeal fracture with microplate and Kirschner wire[J].zhongguo gu shang / China J Orthop Trauma ,2004,17(2):68~70 |
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