微型钢板与克氏针斜向及邻掌骨横向内固定治疗掌骨干斜行骨折疗效观察
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作者Author单位AddressE-Mail
施立奇 SHI Li-qi 余姚市中医医院骨科, 浙江 余姚 315400 Department of Orthopaedics, Hospital of Traditional Chinese Medicine of Yuyao City, Yuyao 315400, Zhejiang, China timothy1324@163.com 
汤样华 TANG Yang-hua 杭州市萧山区中医院骨科, 浙江 杭州 311201 Department of Orthopaedics, Xiaoshan District Hospital of Traditional Chinese Medicine of Hangzhou, Hangzhou 311201, Zhejiang, China  
李象钧 LI Xiang-jun 余姚市中医医院骨科, 浙江 余姚 315400 Department of Orthopaedics, Hospital of Traditional Chinese Medicine of Yuyao City, Yuyao 315400, Zhejiang, China  
赵俊 ZHAO Jun 余姚市中医医院骨科, 浙江 余姚 315400 Department of Orthopaedics, Hospital of Traditional Chinese Medicine of Yuyao City, Yuyao 315400, Zhejiang, China  
刘杰 LIU Jie 余姚市中医医院骨科, 浙江 余姚 315400 Department of Orthopaedics, Hospital of Traditional Chinese Medicine of Yuyao City, Yuyao 315400, Zhejiang, China  
期刊信息:《中国骨伤》2023年,第36卷,第5期,第440-444页
DOI:10.12200/j.issn.1003-0034.2023.05.009
基金项目:
中文摘要:

目的:比较微型钢板与克氏针斜向及邻掌骨横向固定治疗掌骨干斜行骨折的临床疗效。

方法:选择自2018年1月至2021年9月收治的59例掌骨干斜行骨折患者为研究对象,根据内固定方法的不同分为观察组(29例)和对照组(30例),观察组采用克氏针斜向及邻掌骨横向内固定,对照组采用微型钢板内固定。比较两组术后并发症、手术时间、切口长度、骨折愈合时间、治疗费用及掌指关节功能。

结果:观察组1例发生克氏针针道感染,其余患者均未发生切口及克氏针针道感染。所有患者未发生内固定松动、断裂和骨折复位丢失。观察组手术时间、切口长度分别为(20.5±4.2) min、(1.6±0.2) cm,明显短于对照组的(30.8±5.6) min、(4.3±0.8) cm(P<0.05);观察组治疗费用和骨折愈合时间分别为(3804.5±300.8)元、(7.2±1.1)周,低于对照组的(9906.9±860.6)元、(9.3±1.7)周(P<0.05)。术后第1、2、3个月观察组掌指关节功能优良率均明显高于对照组(P<0.05),但术后6个月组间比较差异无统计学意义(P>0.05)。

结论:微型钢板内固定和克氏针斜向及邻掌骨横向内固定均是治疗掌骨干斜行骨折的可选术式,但后者具有手术创伤小、手术时间短、有利于骨折愈合、内固定材料费用低和无须二次切开取出内固定等优势。
【关键词】掌骨干骨折  骨折内固定术  克氏针  微型钢板
 
Efficacy of micro steel plate and Kirschner needle oblique and transverse internal fixation of adjacent metacarpal bone in the treatment of metacarpal diaphyseal oblique fracture
ABSTRACT  

Objective To compare the clinical efficacy of micro steel plate and Kirschner needle oblique and transverse internal fixation of adjacent metacarpal bone in the treatment of metacarpal diaphyseal oblique fracture.

Methods Fifty-nine patients with metacarpal diaphyseal oblique fractures admitted between January 2018 and September 2021 were selected as the study subjects and divided into the observation group (29 cases) and the control group (30 cases) based on different internal fixation methods. The observation group was treated with Kirschner wire oblique and transverse internal fixation of adjacent metacarpal bones,while the control group was treated with micro steel plate internal fixation. Postoperative complications,operation time,incision length,fracture healing time,treatment cost,and metacarpophalangeal function were compared between the two groups.

Results No incision or Kirschner wire infections occurred in the 59 patients,except for one in the observation group. No fixation loosening,rupture,or loss of fracture reduction occurred in any of the patients. The operation time and incision length in the observation group were (20.5±4.2) min and (1.6±0.2) cm,respectively,which were significantly shorter than those in the control group (30.8±5.6) min and (4.3±0.8) cm (P<0.05). The treatment cost and fracture healing time in the observation group were (3 804.5±300.8) yuan and (7.2±1.1) weeks,respectively,which were significantly lower than those in the control group (9 906.9±860.6) yuan and (9.3±1.7) weeks (P<0.05). The excellent and good rate of metacarpophalangeal joint function in the observation group was significantly higher than that in the control group at 1,2,and 3 months after operation (P<0.05),but there was no significant difference between the two groups at 6 months after operation (P>0.05).

Conclusion Micro steel plate internal fixation and Kirschner wire oblique and transverse internal fixation of adjacent metacarpal bones are both viable surgical methods for treating metacarpal diaphyseal oblique fractures. However,the latter has the advantages of causing less surgical trauma,shorter operation time,better fracture healing,lower cost of fixation materials,and no need for secondary incision and removal of internal fixation.
KEY WORDS  Metacarpal shaft fractures  Fracture internal fixation  Kirschner needle  Micro steel plate
 
引用本文,请按以下格式著录参考文献:
中文格式:施立奇,汤样华,李象钧,赵俊,刘杰.微型钢板与克氏针斜向及邻掌骨横向内固定治疗掌骨干斜行骨折疗效观察[J].中国骨伤,2023,36(5):440~444
英文格式:SHI Li-qi,TANG Yang-hua,LI Xiang-jun,ZHAO Jun,LIU Jie.Efficacy of micro steel plate and Kirschner needle oblique and transverse internal fixation of adjacent metacarpal bone in the treatment of metacarpal diaphyseal oblique fracture[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(5):440~444
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