钛锁定板和螺钉固定与顺式髓内针治疗不稳定掌、指骨骨折的疗效分析

The curative effect of locking titanium plate and screw fixation combined with antegrade intramedullary nail in the treatment of unstable metacarpal and phalanx fractures

目的探讨钛锁定板和螺钉固定与顺式髓内针治疗不稳定掌、指骨骨折的疗效。方法我院100例不稳定掌、指骨骨折患者,按随机数字法分为对照组和观察组各50例,对照组给予钛锁定板和螺钉固定治疗,观察组给予顺式髓内针治疗,比较两组手术时间、术中出血量、术后住院时间、骨折愈合时间、临床治疗优良率及术后并发症。结果观察组手术时间、术中出血量、术后住院时间均短于对照组(P <0. 05),两组的骨折愈合时间差异无统计学意义(P> 0. 05);观察组术后总并发症发生率低于对照组(P <0. 05),两组优良率比较差异无统计学意义(P> 0. 05)。结论钛锁定板和螺钉固定与顺式髓内针治疗不稳定掌、指骨骨折患者的疗效相当,但顺式髓内针手术时间、术中出血量及术后住院时间短,且安全性较高,值得临床进一步推广。

Objective To analyze the curative effect of locking titanium plate and screw fixation combined with antegrade intramedullary nail in the treatment of unstable metacarpal and phalanx fractures.Methods One hundred patients with unstable metacarpal and phalanx fractures admitted in our hospital were randomly divided into control or observation group,50 in each group.The control group was treated with locking titanium plate and screw fixation while the observation group was treated with antegrade intramedullary nail.The surgical time,intraoperative blood loss,postoperative hospitalization stay,fracture-healing time,excellent and good rate of clinical treatment and postoperative complications were compared between the two groups.Results The surgical time,intraoperative blood loss and postoperative hospitalization stay of the observation group were shorter/less than those of the control group(P<0.05).There was no significant difference in the fracture healing time between the two groups(P>0.05).The total incidence of complications in the observation group was significantly less than that in the control group(P<0.05).There was no significant difference in the excellent and good rate between the two groups(P>0.05).Conclusion Although curative effect of locking titanium plate and screw fixation are equivalent to antegrade intramedullary nail in the treatment of unstable metacarpal and phalanx fractures,the duration of surgery with the later method is shorter,the intraoperative blood loss is less and postoperative hospitalization stay is shorter.Thus,the antegrade intramedullary nail has higher safety.