微型钢板与交叉克氏针内固定治疗手掌和指骨干骺部骨折疗效比较

The internal fixation procedures of miniplate and cross Kirschner wire for metacarpal and phalangeal metaphysis fractures

目的比较微型钢板和交叉克氏针内固定治疗手掌、指骨干骺部骨折的临床效果。方法回顾性分析90例手掌、指骨干骺部骨折患者的临床资料,其中克氏针内固定组44例(指),微型钢板内固定组46例(指);比较2组患者治疗效果、手术时间、骨折愈合时间、住院时间、术后伤口感染率及其他并发症发生情况。结果克氏针内固定组优良率(79.54%)高于微型钢板内固定组(56.52%),差异有统计学意义(P<0.01)。克氏针内固定组关节僵硬和肌腱粘连发生率低于微型钢板内固定组(P<0.01);2组均未出现骨折延迟愈合或不愈合,且2组伤口感染率比较差异无统计学意义(P>0.05)。2组手术时间比较差异有统计学意义(P<0.05),但骨折愈合时间和住院时间比较差异无统计学意义(P>0.05)。结论交叉克氏针内固定治疗手掌、指骨干骺部骨折,手指关节功能恢复明显优于微型钢板内固定,且手术时间短,并发症少。

Objective To compared the clinical effectiveness of two different internal fixation procedures of miniplate and cross Kirschner wire for metacarpal and phalangeal metaphysis fractures.Methods The clinical data of ninety cases with metacarpal and phalanx fractures were analyzed retrospectively.Ninety cases were divided into Kirschner wire internal fixation group（n=44） and miniplate internal fixation group（n=46）.The therapeutic efficacy,operation time,fracture healing time,length of stay,wound infection rates and the rates of other complication of two groups were compared.Results The excellent rate of Kirschner wire internal fixation group（79.54%） was significantly higher than that in miniplate internal fixation group（56.2%）（P〈0.01）.The incidence rate of joint ankylosis and adhesion of tendon of Kirschner wire internal fixation group was significantly lower than that of miniplate internal fixation group（P〈0.01）.Total of patients did not appear fracture delayed or not heal,and the wound infection rates of two groups was no statistical significance（P〉0.05）.There was statistic difference of operation time between two groups（P〈0.05）,but there were no statistic difference of fracture healing time and length of stay between two groups（P〉0.05）.Conclusion Cross Kirschner wire internal fixation treatment of metacarpal and phalangeal fractures is obviously superior to miniplate fixation on the finger joint functional recovery,and with fewer complications and shorter operation time.