弧形交叉髓内钉与交叉克氏针内固定治疗掌指骨骨折的疗效评价

Curative assessment of arch-crossing intramedullary nail and crossing Kirschner wire in treatment of metacarpal and phalangeal fractures

目的评价掌指骨骨折治疗方法的临床效果。方法均在X线下采用弧形交叉髓内钉内固定30例（36处）及普通交叉克氏针内固定32例（35处）治疗掌骨及近节指骨骨折。结果采用弧形交叉髓内钉内固定者骨折端均达到解剖复位或接近解剖复位，按王肇祥评定标准均达到优，骨折愈合时间4～6周，平均4．8周；采用交叉克氏针内固定者骨折端达到解剖复位或接近解剖复位只有9处，按评定标准优只占26％、良占74％，骨折愈合时间6～8周，平均7．2周。结论两种治疗方法的内固定均较稳固，弧形交叉髓内钉内固定对骨折端的对位愈合效果优于普通交叉克氏针。

Objective To compare therapeutic effect of arch-crossing intramedullary nail and crossing Kirschner wire in treatment of metacarpus and phalange fractures. Methods Under assistance of X-ray, arch-crossing intramedullary nail （30 cases with 36 sites） and crossing Kirschner wire （32 cases with 35 sites） were applied for metacarpal and phalangeal fractures. Results Thirty-six catagmatic sites treated with arch-crossing intramedullay nail all arrived at the standard of anatomic diaplasis or near anatomic diaplasis. The diaplasis graded excellent, with fracture healing time of 4-6 weeks （ mean 4.8 weeks）, according to WANG Zhao-xiang＇ s grading criteria. However, of 35 catagmatic sites treated with Kirschner wire, only 9 sites accorded with the standard of anatomic diaplasis or near anatomic diaplasis. According to grading criteria, 26% of all cases were rated as excellent and 74% as good, with fracture healing time of 6-8 weeks （ mean 7.2 weeks）. Conclusion Both internal fixation methods can attain stable fixation. But arch-crossing intramedullary nail is better than ordinary crossing Kirschner wire in terms of the effect of contraposition and restoration.