微型钢板内固定术与克氏针内固定术对掌指关节周围骨折患者术后恢复的影响

Influences of microplate internal fixationand and Kirschner wire internal fixation on postoperative recovery in patients with metacarpophalangeal periarticular fractures

目的探讨微型钢板内固定术与克氏针内固定术对掌指关节周围骨折患者术后恢复的影响。方法选取2018年1月至2021年3月本科室收治的100例掌指关节周围骨折患者为研究对象,根据治疗方法的不同将其分为试验组和参照组,每组50例。试验组给予微型钢板内固定术,参照组给予克氏针内固定术。比较两组的治疗效果。结果试验组的恢复优良率显著高于参照组,差异具有统计学意义(P<0.05)。手术后,两组的白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平及视觉模拟疼痛量表(VAS)评分均优于手术前,且试验组优于参照组,差异具有统计学意义(P<0.05)。术中及术后1、3 d,试验组的平均动脉压、心率低于参照组,差异具有统计学意义(P<0.05)。术后6个月,两组的手部关节活动、日常生活能力量表(ADL)评分及手指总主动屈曲度(TAFS)均优于手术前,且试验组优于参照组,差异具有统计学意义(P<0.05)。试验组的不良反应总发生率为8.00%,低于参照组的20.00%,差异具有统计学意义(P<0.05);试验组的骨折愈合时间短于参照组,差异具有统计学意义(P<0.05)。结论相较于传统的克氏针内固定术,微型钢板内固定术治疗掌指关节周围骨折的效果显著,患者的生理应激反应更小,术后疼痛感受轻微,值得临床推广。

Objective To investigate the influences of microplate internal fixationand and Kirschner wire internal fixation on postoperative recovery in patients with metacarpophalangeal periarticular fractures.Methods A total of 100 patients with metacarpophalangeal periarticular fractures admitted in our department from January 2018 to March 2021 were selected as the research objects.According to different treatment methods,the patients were divided into experimental group and reference group,with 50 cases in each group.The experimental group was treated with microplate internal fixation,while the reference group was treated with Kirschner wire internal fixation.The treatment effects of the two groups were compared.Results The excellent and good rate of recovery in the experimental group was significantly higher than that in the reference group,and the difference was statistically significant(P<0.05).After operation,the levels of interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)and Visual Analogue Scale(VAS)score of the two groups were better than those before operation,those in the experimental group were better than the reference group,and the differences were statistically significant(P<0.05).During operation and 1 and 3 d after operation,the mean arterial pressure and heart rate of the experimental group were lower than those of the reference group,and the differences were statistically significant(P<0.05).At 6 months after operation,the hand joint mobility,Activity of Daily Living(ADL)score and Total Active Flexion Scale(TAFS)of the two groups were better than those before operation,those in the experimental group were better than the reference group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the experimental group was 8.00%,which was lower than 20.00%in the reference group,and the difference was statistically significant(P<0.05);the fracture healing time in the experimental group was shorter than that in the reference group,and the difference was statistically significant(P<0.05).Conclusion Compared with the traditional Kirschner wire internal fixation,the microplate internal fixation in the treatment of metacarpophalangeal periarticular fracture has a significant effect,with less physiological stress reaction and mild postoperative pain,which is worthy of clinical promotion.