掌骨骨折应用交叉克氏针与有限切开微型钢板内固定的疗效比较

Comparison of the effect of internal fixation with crossed Kirschner wire and limited incision mini plate for metacarpal fracture

目的比较分析掌骨骨折应用交叉克氏针与有限切开微型钢板内固定的疗效。方法回顾性分析2017年8月-2022年8月收治的102例掌骨骨折患者病例资料,随机分为观察组与对照组,各51例。其中观察组应用有限切开微型钢板内固定,对照组采用交叉克氏针固定。比较两组手术指标、术中、术后并发症发生情况及掌功能恢复情况。结果与对照组相比,观察组术中出血量较多,手术时间较长(P<0.05)。术后均随访4~10个月,平均(7.52±2.14)个月,观察组掌功能恢复优良率高于对照组(P<0.05)。观察组术后2例出现疼痛,1例骨缩短,1例成角畸形,并发症发生率为7.84%(4/51);对照组术后1例疼痛,2例术中出现骨缩短,并发症发生率为5.88%(3/51);观察组并发症发生率与对照组比较差异无统计学意义(校正χ^(2)=0.153,P=0.695)。结论在掌骨骨折中,与交叉克氏针相比,有限切开微型钢板内固定术中出血量多,手术时间长,但在促进掌功能恢复方面效果显著,安全可靠。

Objective To compare the effect of internal fixation with crossed Kirschner wire and limited incision mini plate for metacarpal fracture.Methods One hundred and two patients with metacarpal fracture were retrospective analysed and admitted to the hospital from August 1,2017 to August 1,2022,they were randomly divided into the study group and the control group,with 51 patients in each group.In the study group,the limited incision mini plate was used for internal fixation,and the crossed Kirschner wire was used in the control group.The operative indexes were compared,and the intraoperative and postoperative complications and the recovery of palm function were compared.Results Compared with the control group,the intraoperative blood loss of the study group was larger and the operation time was longer(P<0.05).All patients were followed up for 4 to 10 months,with an average of(7.52±2.14)months.The excellent and good rate of palm function recovery in the study group was higher than that in the control group(P<0.05).In the study group,there were 2 cases of pain,1 case of bone shortening,and 1 case of angulation.The total postoperative complication rate was 7.84%(4/51);In the control group,there was 1 case of postoperative pain and 2 cases of intraoperative bone shortening.The total postoperative complication rate was 5.88%(3/51);There was no significant difference in the total complication rate between the study group and the control group(correctionχ^(2)=0.153,P=0.695).Conclusion In metacarpal fracture,compared with cross Kirschner wire,limited incision mini plate internal fixation has a intraoperative blood loss and longer operation time,but can promote the recovery of palm function,and is safe and reliable.