微型钢板和克氏针两种固定方法治疗掌指骨骨折的优劣差异

Treatment of metacarpal and phalangeal fractures with two different fixation methods: mini plate and Kirschner wire

目的探讨微型钢板和克氏针两种固定方法治疗掌指骨骨折的临床效果。方法将2015年1月~2016年12月在我院接受治疗的60例掌指骨骨折患者按照随机数字法平均分为两组,30例患者采用克氏针固定治疗(对照组),30例给予微型钢板固定治疗(研究组)。将两组患者临床疗效、手术时间、住院时间开始功能训练时间、骨折愈合时间、关节屈曲度、并发症情况以及外观满意情况进行比较。结果研究组治疗优良率(90.00%)显著高于对照组(60.00%),P<0.05。研究组患者手术时间及住院时间显著长于对照组,开始功能训练时间、骨折愈合时间显著短于对照组,且关节屈曲度显著大于对照组(P<0.05)。研究组关节僵硬、固定物不良反应及骨折延迟愈合发生率显著低于对照组(P<0.05)。研究组外观满意率(93.33%)显著高于对照组(66.66%),P<0.05。结论在掌指骨骨折治疗中选择微型钢板固定治疗可显著提高治疗效果,缩短患者恢复时间,改善患者手部功能,降低术后并发症发生率,且患者满意度较高。

Objective To explore the clinical effect of metacarpal and phalangeal fractures with two different fixation methods： mini plate and Kirschner wire. Methods 60 cases of metacarpal and phalangeal fracture cured in our hospital from January 2015 to December 2016 were selected and randomly divided into two groups. 30 cases in control group were treated with Kirschner wire fixation, and 30 cases in study group were treated with mini plate fixation. The clinical efficacy, operation time, hospital stay, functional training time, fracture healing time, joint flexion, complications, and appearance satisfaction of the two groups were compared. Results The excellent rate of treatment in the study group（90%） was significantly higher than that in the control group（60%）, P 〈 0.05. The operation time and length of stay in the study＂ group were significantly longer than those in the control group, and the initial functional training time and fracture healing time were significantly shorter than that of the control group, and the joint flexion degree was significantly greater than that of the control group（P 〈 0.05）. The incidence of joint stiffness, adverse effects of instrumentation and delayed union were significantly lower in the study group than in the control group（P 〈 0.05）. The appearance satisfaction rate of the study group（93.33%） was significantly higher than that of the control group（66.66%）, P 〈 0.05. Conclusion In the treatment of metacarpal and phalangeal fractures, the choice of mini plate fixation can significantly improve the treatment effect, shorten the recovery time, improve the hand function, and reduce the incidence of postoperative complications. And the patient satisfaction is higher.