微型钢板内固定与克氏针内固定治疗掌指关节周围骨折临床疗效的回顾性研究

Retrospective Study on the Clinical Efficacy of Micro Steel Plate Internal Fixation and Kirschner Wire Internal Fixation in the Treatment of Metacarpophalangeal Joint Peripheral Fractures

目的:对比掌指关节周围骨折采用克氏针内固定或微型钢板内固定治疗后的临床疗效。方法:回顾性分析2019年8月~2022年12月期间江南大学附属医院收治的掌指关节周围骨折97例患者的临床资料。按照不同的内固定方式将患者分为A组(克氏针内固定治疗,47例)和B组(微型钢板内固定,50例)。对比两组治疗指标[手术时间、骨折愈合时间、住院时间、功能锻炼开始时间]、术后指标[指关节总活动度、手总主动活动度评分]、手功能[手指总主动屈曲度量表(TAFS)评分]、手部疼痛,同时观察两组术后并发症发生情况。结果:B组的功能锻炼开始时间、骨折愈合时间均短于A组,手术时间长于A组(P<0.05),两组住院时间组间对比无差异(P>0.05)。B组的指关节总活动度大于A组,手总主动活动度评分高于A组(P<0.05)。治疗3个月后,两组手部疼痛视觉模拟量表(VAS)评分下降,且B组低于A组(P<0.05)。B组手功能TAFS评分优良率为92.00%,高于A组74.47%(P<0.05)。B组的术后并发症发生率低于A组(P<0.05)。结论:相对于克氏针内固定治疗,微型钢板内固定治疗掌指关节周围骨折,可缩短愈合时间、功能锻炼开始时间,提高手功能,指关节总活动度以及手总主动活动度评分,减轻手疼痛,降低并发症发生率,但其手术时间更长。

Objective:To compare the clinical efficacy of Kirschner wire internal fixation or mini steel plate internal fixation for treatment of metacarpophalangeal joint fractures.Methods:The clinical data of 97 patients with metacarpophalangeal joint periarticular fractures who were admitted to the Affiliated Hospital of Jiangnan University from August 2019 to December 2022 were retrospectively analyzed.Patients were divided into group A(treated with Kirschner wire internal fixation,47 cases)and group B(treated with micro steel plate internal fixation,50 cases)according to different internal fixation methods.The therapeutic indicators[operation time,fractures healing time,hospitalization time,start time of functional exercise],postoperative indicators[total range of finger joints motion,total hand active motion scores],hand function[total finger active flexion scale(TAFS)scores],hand pain were compared between two groups,and the incidence of postoperative complications were simultaneously observed in two groups.Results:The start time of functional exercise and fracture healing time in Group B were shorter than those in Group A,and the surgical time was longer than that in Group A(P<0.05),and there was no statistically significant difference in hospitalization time between two groups(P>0.05).The total range of finger joints motion in group B was greater than that in group A,and the total hand active motion scores was higher than that in group A(P<0.05).3 months after treatment,the visual analogue scale(VAS)scores of hand pain decreased in two groups,and group B was lower than that in group A(P<0.05).The excellent and good rate of hand function TAFS scores in group B was 92.00%,which was higher than 74.47%in group A(P<0.05).The incidence of postoperative complications in group B was lower than that in group A(P<0.05).Conclusion:Compared to Kirschner wire internal fixation,micro steel plate internal fixation for the treatment of fractures around the metacarpophalangeal joint can shorten the healing time,start functional exercise time,improve hand function,total finger joint mobility,and total active hand mobility score,reduce hand pain,and reduce the incidence of complications,but its surgical time is longer.