指掌骨骨折合并软组织损伤的微型锁定钢板皮外固定应用效果及对关节活动度的影响

Application Effect of Mini Lockin Plate External Fixation for Metacarpal Fracture with Soft Tissue Injury and Its Influence on Joint Range of Motion

目的:探讨指掌骨骨折合并软组织损伤的微型锁定钢板皮外固定的应用效果及对关节活动度的影响。方法:选取我院2015年7月到2020年7月共收治的80例指掌骨骨折合并软组织损伤的患者作为研究对象,将其随机分为观察组与对照组,各40例。对照组应用克氏针、微型螺钉、肌腱缝线或拉力螺钉进行内固定,观察组在对照组基础上联合应用微型锁定钢板皮外固定,并针对患者合并软组织损伤情况应用石膏外固定。对比两组患者的骨折愈合时间、围术期指标、Jamar握力、TAM、DASH评分、术后不良反应情况以及生活质量。结果:观察组手术时间高于对照组,骨折愈合时间和住院时间较对照组低(P<0.05);观察组患者的DASH评分明显低于对照组,TAM与Jamar握力明显高于对照组(P<0.05);观察组术后并发症发生率较对照组低(P<0.05);术后1个月两组患者生活质量评分均升高,高于对照组(P<0.05)。结论:对指掌骨骨折合并软组织损伤的患者在常规克氏针内固定的基础上,应用微型锁定钢板皮外固定,再进行石膏固定,手术步骤、手术时间虽增加,但更有利于患者术后骨折愈合,减少术后并发症的发生,减少住院时间,促进患者出院后关节功能恢复,提高生活质量,值得临床应用推广。

Objective:To investigate the application effect of mini locking plate for external fixation of metacarpal fractures with soft tissue injury and its influence on the range of motion of joints.Methods:80 cases with metacarpal fracture combined with soft tissue injury in our hospital from July 2015 to July 2020 were selected as the research object,and the patients were randomly divided into the observation group and control group,40 cases in each group.The patients in the control group were treated with Kirschner wire,micro screw,tendon suture or lag screw for internal fixation,while the patients in the observation group were treated with micro locking plate combined with external fixation on the basis of the control group,and plaster external fixation was applied for patients with soft tissue injury.The fracture healing time and perioperative indicators of the two groups were compared.The Jamar grip strength scores,TAM and dash in two groups were compared.The postoperative adverse reactions and quality of life of the two groups were compared.Results:The operation time in the observation group was significantly higher than that of the control group,the healing time and hospitalization time of the fracture were significantly lower than that of the control group(P<0.05).The DASH score in the observation group was significantly lower than that of control group,and the grip strength of TAM and Jamar was significantly higher than that of control group(P<0.05).The incidence of postoperative complications in the observation group was lower than that of the control group(P<0.05).The quality of life score of the two groups was increased one month after operation,and the mental health,emotional function,social function,vitality,physiological function of the observation group were higher The physiological function and overall health were significantly higher than that of the control group(P<0.05).Conclusion:On the basis of conventional Kirschner wire internal fixation,micro locking plate external fixation combined with plaster fixation can increase the operation steps and operation time,while was more conducive to the fracture healing,reduce the occurrence of adverse reactions,reduce the length of hospital stay,and promote the recovery of joint function after discharge,It is worthy of clinical application and promotion to improve the quality of life.