孔祥涛 赵冰

【摘要】目的探究克氏針内固定或微型钢板置入内固定治疗掌指骨骨折的临床疗效。方法回顾性分析2014年1月～2016年1月间收治的110例掌指骨骨折患者临床资料，根据内固定方法分为研究组（微型钢板置入，n=52例/67处）和对照组（克氏针，n=58例/74处）。随访1年，观察两组恢复进程（住院时间、康复训练开始时间、骨折愈合时间），评估随访3个月后疗效，记录不良事件发生率。结果①110例患者141处骨折均获得随访，随访时间3～14个月，术后随访中所有骨折均愈合，无肌腱断裂、不愈合等情况出现；对照组中4例因感染致使骨折愈合延迟，经治疗后恢复良好。②研究组康复训练开始时间和骨折愈合时间短于对照组（P<0.001），两组住院时间对比差异无统计学意义（P>0.05）；随访3个月，研究组疗效优良率高于对照组（P<0.05）。③研究组总不良反应发生率较对照组低（P<0.05）。结论微型钢板置入治疗掌指骨骨折较克氏针内固定疗效优良率高，且可降低患者不良反应发生率和缩短其恢复进程，临床应用价值可观。

【关键词】骨折；掌指骨；克氏针；微型钢板；内固定

中图分类号：R683.41 文献标识码：ADOI：10.3969/j.issn.10031383.2018.02.016

Observation of therapeutic effect of two internal fixation

methods for metacarpophalangeal fracture

KONG Xiangtao，ZHAO Bing

（The Second Peoples Hospital of Xinxiang，Xinxiang 453000，China）

【Abstract】ObjectiveTo investigate the clinical effect of Kirschner wire internal fixation and miniplate internal fixation in the treatment of metacarpophalangeal fracture.MethodsThe clinical data of 110 patients with metacarpophalangeal fracture admitted to hospital from January 2014 to January 2016 were analyzed retrospectively.According to the internal fixation method，all patients were divided into two groups：study group （n=52/67 metacarpophalangeal fractures） and control group （n=58/74 metacarpophalangeal fractures）.The patients were followed up for one year to observe recovery process （hospitalization time，the start time of rehabilitation training and fracture healing time）.The curative effect was evaluated after 3 months of followup，and the incidence of adverse events was recorded.Results ①110 patients with 141 metacarpophalangeal fractures were followed up for 3～14 months.All the fractures were healed，no tendon rupture and nonunion occurred during the followup，while 4 cases in the control group were delayed to heal due to infection，and recovered well after treatment.② The start time of rehabilitation training and fracture healing time of the study group were shorter than those of the control group（P<0.001），and the difference of hospitalization time between the 2 groups was not statistically significant（P>0.05）.After 3 months of followup，the excellent and good rate in the study group was higher than that in the control group （P<0.05）.③The incidence of total adverse reactions in the study group was lower than that in the control group（P<0.05）.ConclusionMiniplate internal fixation for metacarpophalangeal fracture is better than Kirschner wire internal fixation，it is effective in reducing the incidence of adverse reactions and shortening the process of recovery with considerable value of clinical application.

【Key words】fracture；metacarpophalangeal bone；Kirschner wire；miniplate；internal fixation

掌指骨骨折是临床发生率较高的创伤，由于其结构复杂且手对患者精细动作能力影响较大[1]，同时复位固定疗效又是获得良好预后状况的基础，所以如何选择合适的内固定方式受到高度关注。近年来已有较多文献指出，克氏针和微型钢板置入内固定法较石膏、夹板等传统固定方式更具有优势[2]，故这两种手段在临床运用率较高。克氏针内固定具有不经过关节固定、费用低和无需再次手术等优点；微型钢板固定牢固，可有效对抗掌指骨屈曲的压力。基于上述优势，本研究对掌指骨骨折患者分别采用微型钢板和克氏针固定，以探究不同内固定方法治疗掌指骨骨折的优劣，现报告如下。……