可吸收材料内固定处理指骨骨折的回顾性研究

Retrospective study on the treatment of phalanx fractures with absorbable materials

目的:探讨可吸收材料内固定处理指骨骨折的效果及对超敏C反应蛋白(hs-CRP)、白细胞介素10(IL-10)、促肾上腺皮质激素(ACTH)水平和异物反应的影响。方法:收集2018年1月至2020年1月无锡市惠山区人民医院诊治的98例指骨骨折患者的临床资料,按手术方式的不同分为可吸收组(49例,采取可吸收材料内固定治疗)及微型钢板组(49例,采取微创钢板内固定治疗)。比较两组治疗优良率、手术情况、围手术期hs-CRP、IL-10、ACTH水平变化和术后3、6个月恢复情况。结果:可吸收组治疗优良率高于微型钢板组[95.92%(47/49)比81.63%(40/49)],差异有统计学意义(χ^(2)=5.02,P<0.05)。可吸收组手术时间长于微型钢板组[(43.28±12.18)min比(31.29±11.69)min],住院时间、骨折愈合时间、恢复工作时间短于微型钢板组[(4.09±1.18)d比(6.89±2.12)d、(4.35±1.05)周比(5.69±1.38)周、(4.89±1.10)d比(6.20±2.01)d],差异均有统计学意义(P<0.05)。可吸收组术后1 d和1周血清hs-CRP、IL-10、ACTH水平均低于微型钢板组(P<0.05)。可吸收组术后3、6个月掌指关节活动度大于微型钢板组,握力相比健侧丢失度小于微型钢板组(P<0.05)。可吸收组并发症发生率低于微型钢板组[6.12%(3/49)比20.41%(10/49)],差异有统计学意义(χ^(2)=4.35,P<0.05)。结论:采取可吸收材料内固定处理指骨骨折可取得良好效果,术后康复快,并发症发生率较低。

Objective To investigate the effect of absorbable material internal fixation in the treatment of phalanx fracture and its effect on the complications related to hypersensitive C-reactive protein(hs-CRP),interleukin-10(IL-10),adrenocorticotropic hormone(ACTH)and foreign body reaction.Methods The clinical data of 98 patients with phalangeal fracture in Huishan District People′s Hospital of Wuxi City from January 2018 to January 2020 were divided into absorbable group(49 cases,treated with absorbable material internal fixation)and microplate group(49 cases,treated with minimally invasive plate internal fixation).The rates of excellent and good treatment,operation conditions,serum inflammatory stress response indexes levels before and 1 d and 1 week after surgery were compared,and recovery at 3 and 6 months after surgery,the incidence of complications and the degree of treatment satisfaction were counted.Results The rates of excellent and good treatmentin the absorbable group were higher than that in the micro plate group:95.92%(47/49)vs.81.63%(40/49),χ^(2)=5.02,P<0.05.The duration of operation in the absorbable group was longer than that in the microplate group:(43.28±12.18)min vs.(31.29±11.69)min;and the duration of hospital stay,fracture healing time and recovery time were shorter than those in the microplate group:(4.09±1.18)d vs.(6.89±2.12)d,(4.35±1.05)weeks vs.(5.69±1.38)weeks,(4.89±1.10)d vs.(6.20±2.01)d;the differences were statistically significant(P<0.05).The levels of serum hs-CRP,IL-10 and ACTH in absorbable group were lower than those in microplate group at 1 d and 1 week after surgery(P<0.05).At 3 and 6 months after surgery,the range of motion of metacarpophalangeal joint in the absorbable group was greater than that in the microplate group,and the loss of grip strength of the healthy side was less than that in the microplate group(P<0.05).The incidence of complications in absorbable group was lower than that in microplate group:6.12%(3/49)vs.20.41%(10/49),χ^(2)=4.35,P<0.05.Conclusions The absorbable material internal fixation can achieve good results in the treatment of phalanx fracture,the postoperative recovery is fast,the incidence of complications is lower.