无头加压螺钉内固定对指掌骨骨折患者的疗效

Effects of Headless Compression Screw Internal Fixation in Patients with Metacarpal Bone Fractures

目的探讨无头加压螺钉内固定对指掌骨骨折患者手功能及安全性的影响。方法前瞻性纳入南阳市第一人民医院骨科于2019年9月至2022年6月收治的85例指掌骨骨折患者进行研究,根据随机数字表法分为对照组(42例)和观察组(43例)。对照组在排除手术禁忌后接受克氏针内固定治疗,观察组患者接受无头加压螺钉内固定治疗。于术后6个月,根据指掌骨骨折愈合情况评定治疗效果;于术前、术后6个月,通过上肢功能测试(UEFT)、组块测试(BBT)、Jebsen七项手功能测试(JHFT)评定患者手功能恢复情况;比较术前、术后7 d时视觉模拟评分法(VAS)评分;比较术后6个月内感染、骨不愈、肌腱粘连、指骨缩短等并发症发生情况。结果观察组治疗总有效率高于对照组(P<0.05)。术后6个月,两组UEFT、BBT数值均升高,且观察组高于对照组;两组JHFT数值下降,且观察组低于对照组(P<0.05)。术后7 d,两组VAS评分均下降,且观察组低于对照组(P<0.05)。术后6个月,观察组并发症发生率低于对照组(P<0.05)。结论无头加压螺钉内固定能促进指掌骨骨折患者手功能的恢复,且并发症发生率低,具有较高安全性。

Objective To investigate the effect of headless compression screw internal fixation on hand function and safety in patients with metacarpal bone fractures.Methods A prospective study was conducted on 85 patients with metacarpal bone fractures admitted to the Department of Orthopedics of Nanyang First People’s Hospital from September 2019 to June 2022.They were divided into control group(42 cases)and observation group(43 cases)by random number table method.The control group received Kirschner wire internal fixation after eliminating surgical contraindications,while the observation group received headless compression screw internal fixation.At 6 months after surgery,the treatment effect was evaluated based on the healing of the metacarpal bone fractures.Before and 6 months after surgery,the patients’hand function recovery was evaluated by upper extremity function test(UEFT),box and block test(BBT),and Jebsen seven item hand function test(JHFT).The visual analogue scale(VAS)scores were compared before and 7 days after surgery.The incidence of complications such as infection,bone nonunion,tendon adhesion and phalangeal shortening within 6 months after surgery was compared.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).Six months after surgery,the UEFT and BBT values in both groups were higher,and the observation group was higher than the control group(P<0.05).The JHFT value of both groups decreased,and the observation group was lower than the control group(P<0.05).On the 7th day after operation,the VAS score of both groups decreased,and the observation group was lower than the control group(P<0.05).Within 6 months after surgery,the incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion Headless compression screw internal fixation can promote the recovery of hand function in patients with metacarpal bone fractures,with a low incidence of complications and high safety.