微型空心螺钉内固定术与传统克氏针交叉内固定术治疗掌指骨骨折患者的效果比较

Comparison of effects of miniature hollow screw internal fixation and traditional Kirschner wire cross internal fixation in treatment of patients with metacarpophalangeal fractures

目的:比较微型空心螺钉内固定术与传统克氏针交叉内固定术治疗掌指骨骨折患者的效果。方法:回顾性分析2020年4月至2023年6月该院收治的119例掌指骨骨折患者的临床资料,根据手术方法不同将其分为观察组(n=61)和对照组(n=58)。观察组行微型空心螺钉内固定术治疗,对照组行传统克氏针交叉内固定术治疗,比较两组围术期指标(医疗费用、手术时间、住院时间、透视次数)水平,术后指功能优良率,手术前后疼痛应激指标[白细胞介素-1β(IL-1β)、前列腺素E2(PGE2)、5-羟色胺(5-HT)]水平,以及术后1周并发症发生率。结果:观察组医疗费用高于对照组,手术时间、住院时间均短于对照组,透视次数少于对照组,差异有统计学意义(P<0.05);观察组术后指功能优良率为98.36%(60/61),高于对照组的86.21%(50/58),差异有统计学意义(P<0.05);术后2、4 d,两组血清IL-1β、PGE2、5-HT水平均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:微型空心螺钉内固定术治疗掌指骨骨折患者可提高术后指功能优良率,缩短手术时间和住院时间,减少透视次数,降低疼痛应激指标水平,效果优于传统克氏针交叉内固定术治疗,但医疗费用较高。

Objective:To compare effects of miniature hollow screw internal fixation and traditional Kirschner wire cross internal fixation in treatment of patients with metacarpophalangeal fractures.Methods:The clinical data of 119 patients with metacarpophalangeal fractures admitted to this hospital from April 2020 to June 2023 were retrospectively analyzed.According to different surgical methods,they were divided into observation group(n=61)and control group(n=58).The observation group was treated with miniature hollow screw internal fixation,while the control group was treated with traditional crossing Kirschner wire internal fixation.The perioperative indexes(medical expenses,operation time,hospitalization time,fluoroscopy times)levels,the excellent and good rate of postoperative finger function,the levels of pain stress indexes[interleukin-1β(IL-1β),prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT)]before and after the surgery,and the incidence of complications 1 week after the surgery were compared between the two groups.Results:The medical expenses of the observation group was higher than that of the control group,the operation time and the hospitalization time were shorter than those of the control group,the fluoroscopy times was less than that of the control group,and the differences were statistically significant(P<0.05).The excellent and good rate of postoperative finger function in the observation group was 98.36%(60/61),which was higher than 86.21%(50/58)in the control group,and the difference was statistically significant(P<0.05).At 2 and 4 days after the surgery,the levels of serum IL-1β,PGE2 and 5-HT in the two groups were lower than those before the surgery,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:Miniature hollow screw internal fixation in the treatment of the patients with metacarpophalangeal fractures can improve the excellent and good rate of postoperative finger function,shorten the operation time and the hospitalization time,reduce the fluoroscopy times,and reduce the levels of pain stress indexes.It is superior to traditional crossing Kirschner wire internal fixation,but the medical expense is higher.