微型钢板与克氏针固定术治疗掌指骨骨折的疗效比较

Efficacy comparison of mini - plate and kuntscher pin in the treatment of metacarpus and phalange fracture

目的：比较克氏针固定术（KPF）与AO微型钢板骨钉（AOM）术式在掌骨骨折（FMB）和FPB治疗中的临床效果。方法将113例 FMB 和 FPB 患者作为观察对象，按随机数字表法分为 OSG 组（58例）和CTG 组（55例），分别采用 KPF 和 AOM术式治疗，统计两组患者的术后恢复和并发症情况进行统计分析。结果OSG 组58例患者术后2～5指掌指关节至指间关节总主动弯曲度大于220°有28例（48．28％，χ2＝8．562，P ＝0．035），180～220°有19例（32．76％，χ2＝8．935，P ＝0．024），小于180°有11例（18．97％，χ2＝9．025，P ＝0．015）；拇指掌指关节至指间关节总主动弯曲度大于220°有30例（51．72％，χ2＝9．365，P ＝0．012），180～220°有18例（31．03％，χ2＝8．747，P ＝0．009），小于180°有10例（17．24％，χ2＝8．932，P ＝0．041），显著优于 CTG 组，P ＜0．05。另 OSG 组患者平均骨折愈合时间（52．62±14．89）min，术后并发症27例；CTG 组平均骨折愈合时间（64．28±16．38）min，术后并发症77例，差异有统计学意义（P ＜0．05）。结论AOM术式治疗 FMB 和 FPB 手术复位准确，固定牢靠，功能恢复快，术后并发症少，值得推广借鉴。

Objective To investigate the clinical effect of mini -plate and kuntscher pin fixation in the treatment of metacarpus and phalange fracture.Methods 113 FMB and FPB patients were divided into OSG （58 patients）and CTG（585patients）group according to random number table.Statistics of postoperative recovery and complications in the two groups were collected and analyzed after research.Results In 58 patients of OSG group,the total active bending from 2 -5 metacarpophalangeal joints to phalangeal joints of 28 cases（48.28%,χ2 =8.562,P =0.035 ）were beyond 220°,19 cases （32.76%,χ2 =8.935,P =0.024）were between 180 -220°, 11 cases （51.72%,χ2 =9.365,P =0.012）were less than 180°.The total active bending fromthumb metacarpopha-langeal articulation to interphalangeal joint of 30 cases （51.72%,χ2 =9.365,P =0.012）were beyond 220°, 18 cases （31.03%,χ2 =8.747,P =0.009）were between 180 -220°,10 cases （17.24%,χ2 =8.932,P =0.041） were less than 180°（P 〈0.05）.Conclusion AO Mini -plates surgical method has advantage of parking position accuracy,dissection stable fixation,functional recovery soon and less complication in the treatment of FMB and FPB patients,which is worthy of promotion.