微型钢板与克氏针治疗掌指骨骨折疗效比较

Comparison of effects of mini-plates and Kirschner wire for the treatment of metacarpal and phalangeal fractures

目的评估微型钢板治疗掌指骨骨折的临床疗效。方法采用微型钢板治疗掌指骨骨折25例（28处）。克氏针内固定治疗31例（35处），比较两种手术的治疗效果。结果经2～12个月随访，微型钢板内固定组25例（28处）骨折全部愈合，其中2例（2处）延迟愈合，骨折平均愈合时间4．6周。参照TAFS评分标准，优16例，良6例，差3例，优良率88％。克氏针内固定组3例（3处）出现畸形愈合，5例（5处）延迟愈合，1例（1处）骨不连，余骨折全部正常愈合。骨折平均愈合时间7．8周，优20例，良3例。差8例，优良率74．2％。两组问优良率有显著差异（P〈0.05）。结论微型钢板治疗掌指骨骨折固定牢靠。能早期功能锻炼。其疗效明显优于克氏针组。

Objective To evaluate the clinical effects of mini - plates in treatment of metacarpal and phalangeal fractures. Methods Twenty five cases （28 metacarpal and phalangeal fractures） were performed with. Thirty one cases （35 metacarpal and phalangeal fractures） were treated with internal fixation with Kirschner wire, Comarison of curative effects of two operations were performed, Results Twenty five cases were followed up for 2 to 12 months, in mini-plates group, mean healing time were 4, 6 weeks. All 25 cases fractures healed. Two cases suffered delayed union. According to the TAFS Scoring System： sixteen cases were excellent, 6 cases were fine, 3 cases were bad. The rate of excellent and good was 88%, In Kirschner＇ s group, the mean healing time were 7.8 weeks. Three cases were malunion, 5 cases suffered delayed union, 1 case was nonunion, the other fractures healed normally. Mean healing time were 7.8 weeks. Twenty cases were excellent, 3 cases were good, 8 cases were bad. The rate of excellent and good was 74.2 % , There was significant difference in rate of excellent and good between two groups （P〈 0.05）. Conclusion Compared with the Kirschner wire, efficacy of mini-plates for the treatment of metacarpal and Phalangeal fractures was better. Mini-plates has advantages of rigid fixation and possibility of early functional exercise.