微型钢板内固定治疗掌骨干骨折的疗效分析

目的研究并分析微型钢板内固定和克氏针内固定治疗掌骨干骨折的疗效。方法选择2007年3月～2009年3月因掌骨干骨折而接受手术治疗的患者75例为研究对象,术后随访2～14月,平均4.1月,其中45例经切开复位行微型钢板及螺丝钉内固定术,30例为经手法复位或切开复位行克氏针固定术,以TAM评分为评价标准,并记录感染、骨折延迟愈合、骨不连、关节僵硬等并发症发生情况。结果微型钢板组骨折愈合时间为4～6周,平均(4.2±1.6)周,克氏针组骨折愈合时间为5～9周,平均(7.9±1.4)周。克氏针组病例骨折愈合时间明显长于微型钢板组(P<0.05)。微型钢板组优良率为92.0%,克氏针固定组优良率为70.0%。克氏针组的骨延迟愈合、骨不连发生率为6.7%,而微型钢板组的发生率为0,两组经精确概率法检验差异有统计学意义(P<0.05)。而感染两组的发生率差异无统计学意义(P<0.05)。结论微型钢板治疗掌骨骨折在术后关节功能恢复情况、骨折愈合时间、并发症发生等指标上明显优于交叉克氏针固定,是掌骨骨折较为理想的治疗手段。

Objective To compare intramedullary Kirschner wire fixation（KWF） with miniplate screw fixation（MSF） for treatment of metacarpal shaft fracture. Methods Seventy-five patients of metacarpal shaft fracture with operative treatment by following up between two months and 14 months（average 4.1 months） were selected from March,2007 to March,2009. Thirty cases were carried out with closed reduction and KWF or with open reduction and KWF and 45 cases were treated by open reduction using MSF,and most cases showed either excellent or good results on TAM. Results The healing time in KWF was（7.9±1.4）weeks（from 5 to 9 weeks） ,while that in MSF was （4.2±1.6） weeks（from 4 to 6 weeks）,there was signifi cant difference between two groups（P0.05）.The good-excellent rate in MSF was 92.0%,while that in KWF was 70.0%（P0.05）. The rate of late healed and nonunion in KWF（6.7%） was higher than that in MSF（0）,there was great difference between two groups（P0.05）. there was no difference between two groups（P0.05）. Conclusion The markers of joint function recovery after surgery,the healing time and complication in MSF have an advantage than that in KWF,it is an ideal treatment with miniplate screw fixation for treatment of metacarpal shaft fracture.