闭合复位顺行髓内针内固定治疗第5掌骨颈骨折的效果及对愈合时间、并发症发生率的影响

Curative effect of closed reduction intramedullary nail internal fixation on the fifth metacarpal neck fracture and its influences on healing time and incidence of complications

目的探究闭合复位顺行髓内针内固定治疗第5掌骨颈骨折的应用效果及对患者愈合时间、并发症发生率的影响。方法回顾性分析2020年10月-2021年12月收治的80例第5掌骨颈骨折患者病例资料,根据治疗方案的不同分为观察组(n=43)、对照组(n=37);对照组接受闭合复位克氏针横行固定治疗,观察组接受闭合复位顺行髓内针内固定治疗;比较两组术后30 d、3个月、6个月的握力以及手腕关节功能评分、手术持续时间、术中出血量、X线下骨折愈合时间、手部基本功能恢复时间以及术后并发症发生率。结果观察组的握力、手腕关节功能评定量表评分在术后30 d、3个月的时间点显著高于对照组(P<0.05);然而术后6个月,两组患者的上述指标差异无统计学意义(P>0.05);两组的手术持续时间、术中出血量以及X线检查骨折愈合时间差异均无统计学意义(P>0.05);观察组的手部功能恢复时间短于对照组,差异有统计学意义(P<0.05);两组术后并发症发生率差异无统计学意义(P>0.05)。结论闭合复位顺行髓内针内固定、闭合复位克氏针横行固定均能对第5掌骨颈骨折发挥良好的治疗效果,然而前者术后恢复更加迅速,具有较高的应用价值。

Objective To explore the curative effect of closed reduction intramedullary nail internal fixation on the fifth metacarpal neck fracture and its influences on healing time and incidence of complications.Methods A total of 80 patients with the fifth metacarpal neck fracture admitted to the hospital were retrospectively analyzed between October 2020 and December 2021.According to different treatment methods,they were divided into observation group(n=43)and control group(n=37).The control group was treated with closed reduction Kirschner wire transverse fixation,while the observation group was treated with closed reduction intramedullary nail internal fixation.The scores of grip strength and wrist function at 30d,3 months and 6 months after surgery,operation time,intraoperative blood loss,fracture healing time under X-rays,healing time of basic hand function and incidence of postoperative complications in two groups were compared.Results At 30 d and 3 months after surgery,scores of grip strength and wrist function scale in observation group were significantly higher than those in the control group(P<0.05),but there was no significant difference in the above indexes between two groups at 6 months after surgery(P>0.05).There was no significant difference in operation time,intraoperative blood loss or fracture healing time under X-rays between two groups(P>0.05).However,recovery time of hand function in observation group was shorter than that in control group(P<0.05).There was no significant difference in incidence of postoperative complications between observation group and control group(P>0.05).Conclusion Closed reduction anterograde intramedullary needle fixation and closed reduction Kirschner wire transverse fixation can play a good role in the treatment of the fifth metacarpal neck fracture.However,the former is more rapid and has higher application value.