摘要
目的评估超声在成人指骨骨折治疗中的应用价值,分析超声辅助治疗成人指骨骨折的优缺点及效果。
方法选取我院收治随访的20例成人指骨骨折患者(23指),指骨干骨折14指,指骨基底部骨折6指,指骨髁部骨折3指,均采用术前超声及X线分析,术中超声辅助复位,同时超声引导克氏针闭合穿针固定,记录术中出血量、术中透视次数。随访术后X光片、手指总主动活动度(TAM)及握力。结果术后随访时间6~24个月,平均16个月,超声引导下骨折复位成功17指,6指行C臂下透视复位。骨折平均愈合时间为(6.21±2.10)周。14指TAM评分为优(60.9%),5指为良(21.7%),4指为中或差(17.3%),优良率82.7%。患侧握力(32.5±7.8)kg,健侧握力(34.5±9.9)kg,双侧比较差异无统计学意义(t=0.351,P=0.726)。无骨折不愈合发生。结论超声引导下闭合复位穿针固定指骨骨折,能观察术中对位,明显减少X线辐射,且创伤小、失血少,但对某些类型骨折,如指骨基底部及髁部粉碎性骨折,其效果尚待进一步研究。
Objective To evaluate the value of ultrasound in adults phalangeal fractures, analysze clinical efficacy of ultrasound-assisted closed reduction and pinned fixation of adult phalangeal fracture. Methods A total of 23 phalanx fractures in 20 adult cases were recruited, including shaft fractures 4 fingers, the bottom fracture 13 fingers, and condylar fracture 6 fingers. All cases were examined by preoperative ultrasound and X-ray, intraoperative ultrasound assisted reset, and ultrasound-guided closed reduction were performed. Clinical evaluation included operative time, blooding, fluoroscopy times, the success rate of reduction inoperative, postoperative x-rays, total active motion (TAM) and grip strength. Results The postoperative follow-up ranged from 6 to 24 months, with an average of 16 months. Seventeen fingers were successful by ultrasound-guided closed reduction, and 6 fingers was reduced by C arm fluoroscopy. The average healing time was (6.21± 2.10) weeks. According to the functional evaluation criteria based on TAM, the results were rated as excellent in 14 cases (60.9%), good in 5 cases (21.7%), fair and poor in 4 cases(17.3% ), the total excellent and good rates was 82.7%. Grip strength was (32.5 ± 7.8)kg in affected side and (34.5 ± 9.9)kg in opposite side, there was no significant difference( t = 0.351, P = 0. 726). No nonunion occurred. Conclusions The position can be observed by ultrasound-guided pereutaneous pinning of phalangeal fractures. It's advantages are the less trauma, less blooding, and less X ray exposure. But for some types of fractures, such as the bottom fracture and condylar fracture, the effects should be further studied.
出处
《中华超声影像学杂志》
CSCD
北大核心
2016年第9期804-807,共4页
Chinese Journal of Ultrasonography
关键词
超声检查
指骨骨折
骨折固定术
内
Ultrasonography
Phalangeal fractures
Fracture fixation, internal