第五掌骨颈骨折夹板的设计及不同体位夹板外固定的效果研究

The Design of Splint for the Fracture of the Fifth Metacarpal Neck and the Efficacy of Splint External Fixation in Different Positions

目的:探讨第五掌骨颈骨折应用一种固定夹板,在闭合复位中应用3种不同的体位夹板外固定的方式来进行治疗,对比其疗效,择优出最佳类型。方法:选取2019年9月至2021年6月确诊为第五掌骨颈骨折的患者,并在其中选取60例,选取的患者必须有完整的病例资料,分为3组,每组20例。每组采用不同的体位方式来进行外固定,A组采用屈曲位,B组采用功能位,C组采用伸直位。经过治疗后,对比3种不同的闭合复位的夹板外固定方式对于第五掌骨颈骨折患者的治疗效果。结果:经过治疗后,所有患者都获得了随访,随访时间为3~12个月,平均为(5.50±2.31)个月,三组患者经过治疗后的效果以及患者的满意度没有较大的差异,但定量对比掌指关节活动度范围、手指总的主动活动度等,证实3种固定体位中功能位优势明显,且在患者舒适性、骨折断端稳定性、功能恢复时效性等方面均更优。结论:功能体位外固定方式治疗第五掌骨骨折效果良好,功能位外固定效果最佳,故该固定装置在功能位固定掌骨颈骨折固定效果好、骨折愈合快、功能恢复早,值得推广使用。

Objective:To explore the application of a fixed splint for metacarpal fracture in patients with fifth metacarpal neck fracture, and explore the application of three different external fixation methods of splint in closed reduction, compare the efficacy, and choose the best type for solving the fixed position disputes.Methods:60 patients diagnosed as the fifth metacarpal neck fracture with complete case data in hospital were selected from September 2019 to June 2021.They were divided into three groups with 20 patients in each group.Different body positions were used for external fixation in each group.Patients in group A were in flexion position;patients in group B were in functional position, and patients in group C were in extension position.The efficacy of three different closed reduction splint external fixation methods on the treatment of patients with fifth metacarpal neck fracture were compared after treatment.Results:All patients were followed up for 3 to 12 months, with(5.50±2.31) months on average after treatment.There was no significant difference between the 3 groups in terms of treatment outcome and patient satisfaction.However, the quantitative comparison of the range of motion of metacarpophalangeal joints and the total active motion of fingers confirmed that the functional position had obvious advantages in the three fixed positions, and was superior in the comfort of patients, the stability of fracture end and the timeliness of functional recovery.Conclusion:External fixation in functional position has a good efficacy for the fifth metacarpal fracture, and the external fixation in functional position has the best efficacy.Therefore, the fixation device in functional position has strong fixation efficacy, fast fracture healing and early functional recovery, which is worth popularizing.