闭合复位髓内针固定治疗第五掌骨颈闭合性骨折的疗效研究

Efficacy of closed reduction and intramedullary nailing in the treatment of closed fractures of the fifth metacarpal neck

目的探讨第五掌骨颈闭合性骨折经闭合复位髓内针固定治疗后的临床疗效。方法回顾性分析2017年1月~2021年12月在北京市东城区第一人民医院接受治疗的80例第五掌骨颈闭合性骨折患者的临床资料,按治疗方法将其分为对照组(行钢板内固定治疗)与观察组(行闭合复位髓内针固定治疗),每组40例。观察两组手术指标、疼痛程度(VAS)、手功能评分(DASH)及并发症。结果观察组与对照组比较,前者的手术时间、住院时间、骨折愈合时间明显更短,术中出血量明显更少,差异有统计学意义(P<0.05);与对照组比较,术后2和4周观察组患者VAS评分明显更低,差异有统计学意义(P<0.05);DASH评分比较中,观察组术后2和4周均比对照组低,差异有统计学意义(P<0.05)。结论对第五掌骨颈闭合性骨折患者开展闭合复位髓内针固定治疗,其出血量较少,可有效缓解患者的疼痛程度,促使其手功能恢复,有助于进一步加快患者的骨折愈合速度,缩短其住院时间。

Objective To investigate the clinical effect of closed fracture of the fifth metacarpal neck after closed reduction and intramedullary nailing.Methods The clinical data of 80 patients with closed fracture of the fifth metacarpal neck who were treated in our hospital from January 2017 to December 2021 were retrospectively analyzed,and they were divided into control group according to the treatment method(with steel plate internal fixation).The same as the observation group(with closed reduction and intramedullary needle fixation),40 cases in each group.The surgical indexes,pain level(VAS),hand function score(DASH)and complications were observed in the two groups.Results Compared with the control group,the operation time,hospital stay and fracture healing time of the former group were significantly shorter,and the intraoperative blood loss was significantly less(P<0.05).The VAS score of the patients in the group was significantly lower(P<0.05);in the comparison of the DASH score,the observation group was lower than the control group at 2 and 4 weeks after operation(P<0.05).Conclusion The closed reduction and intramedullary nail fixation for patients with closed fractures of the fifth metacarpal neck can effectively relieve the patient’s pain,promote the recovery of hand function,and further accelerate the fracture healing speed of the patients.,shorten the length of hospital stay.