杨家全 陈坤强 廖建平 龚时国

【摘要】 目的：探討背侧入路与侧方入路微型钢板内固定对指骨骨折愈合及功能恢复的影响。方法：选取2018年3月-2021年2月于九江市第一人民医院治疗的88例指骨骨折患者，按照随机数字表法将其分为背侧入路组和侧方入路组，每组44例。背侧入路组采用背侧入路微型钢板内固定治疗，侧方入路组采用侧方入路微型钢板内固定治疗。比较两组骨折愈合时间、患侧握力、疼痛程度、手指屈伸功能及并发症发生情况。结果：术后6个月，侧方入路组患侧握力（32.97±4.50）kg，高于背侧入路组的（30.58±4.12）kg，差异有统计学意义（P<0.05）。术后2个月，侧方入路组视觉模拟评分法（VAS）评分为（0.69±0.27）分，低于背侧入路组的（1.84±0.36）分，差异有统计学意义（P<0.05）。两组骨折愈合时间比较，差异无统计学意义（P>0.05）。侧方入路组手指屈伸功能优良率为86.36%，高于背侧入路组的68.18%，侧方入路组并发症发生率为6.82%，低于背侧入路组的22.73%，差异均有统计学意义（P<0.05）。结论：在微型钢板内固定术治疗指骨骨折中，采用侧方入路治疗效果优于背侧入路，有利于减轻患者疼痛程度，提高手指关节活动度，增强手部握力，且术后并发症少，临床应用安全性较高。

【关键词】 指骨骨折 微型钢板内固定术 背侧入路 侧方入路 骨折愈合 功能恢复

Influence of Dorsal Approach and Lateral Approach Micro Plate Internal Fixation on Phalanx Fracture Healing and Functional Recovery/YANG Jiaquan， CHEN Kunqiang， LIAO Jianping， GONG Shiguo. //Medical Innovation of China， 2022， 19（16）： 0-077

[Abstract] Objective： To investigate the effect of dorsal approach and lateral approach micro plate internal fixation on phalanx fracture healing and functional recovery. Method： A total of 88 patients with phalanx fracture treated in Jiujiang First People’s Hospital from March 2018 to February 2021 were selected， they were divided into dorsal approach group and lateral approach group according to random number table method， with 44 patients in each group. The dorsal approach group was treated with the dorsal approach with micro plate internal fixation， and the lateral approach group was treated with the lateral approach with micro plate internal fixation. Fracture healing time， grip strength， pain degree， finger flexion and extension function and complications were compared between two groups. Result： 6 months after surgery， the grip strength of the affected side in the lateral approach group was （32.97±4.50） kg， which was higher than （30.58±4.12） kg in the dorsal approach group， the difference was statistically significant （P<0.05）. 2 months after surgery， the visual analog scale （VAS） score in the lateral approach group was （0.69±0.27） points， which was lower than that （1.84±0.36） points in the dorsal approach group， the difference was statistically significant （P<0.05）. There was no significant difference in fracture healing time between two groups （P>0.05）. The excellent and good rate of finger flexion and extension in the lateral approach group was 86.36%， which was higher than 68.18% in the dorsal approach group， the incidence of complications in the lateral approach group was 6.82%， which was lower than 22.73% in the dorsal approach group， the differences were statistically significant （P<0.05）. Conclusion： In the treatment of phalanx fracture with micro-plate internal fixation， the treatment effect of lateral approach is better than dorsal approach， which is beneficial to relieve the pain degree of patients， improve the range of motion of finger joints， enhance the hand grip strength， and less postoperative complications， high clinical application safety.

[Key words] Phalanx fracture Micro plate internal fixation Dorsal approach Lateral approach Fracture healing Functional recovery

First-author’s address： Jiujiang First People’s Hospital， Jiangxi Province， Jiujiang 332000， China

doi：10.3969/j.issn.1674-4985.2022.16.017

指骨骨折作為常见的手部损伤，对患指功能影响较大，甚至会导致截指，给患者心理及生理带来严重伤害。目前指骨骨折的治疗主要以解剖复位、坚强固定为主，以利于患者早期进行功能锻炼及活动，促进手指基本功能恢复[1-2]。……