AO微型钢板螺钉与克氏针治疗掌指骨骨折的比较研究

目的　比较采用AO微型钢板螺钉与克氏针固定治疗掌、指骨骨折的临床效果。方法　AO微型钢板螺钉内固定治疗组 2 0例 2 8处骨折 ,术后随访 2～ 12个月 ,平均 4.7个月。克氏针固定治疗组 3 0例 41处骨折 ,术后随访 1年以上。以TAFS标准评价术后掌指关节及指间关节功能和术后感染及骨折愈合时间。结果　微型钢板固定组优良率为 82 .1% (2 3 / 2 8) ,克氏针固定组优良率为 70 .7(2 9/ 4 1) ,两组差异有显著意义 (P <0 .0 5) ;微型钢板组 19处开放性骨折中 3处发生感染 ,克氏针组 2 9处开放性骨折中 5处发生感染。骨折愈合时间微型钢板组为 4～ 6周 ,平均 4.8周 ;克氏针组为 6～ 9周 ,平均 7.8周 ,2例发生骨不连。结论　从术后关节功能恢复的优良率、感染率以及骨折愈合时间相比 ,AO微型钢板组的疗效明显优于克氏针组

Comparative study of the clinical results of metacarpal and phalangeal fractures fixed by K-wires and AO mini-plates

ObjectiveTo compare the clinical results of metacarpal and p halangeal fractures which were fixed with AO mini-plates and K-wires respectiv ely. Methods20 cases with 28 metacarpal or phalangeal fractures were treate d with A O mini-plates. Follow-up for this group was 4.7 months on average (range 2-12 mo nths). 30 cases with 41 metacarpal or phalangeal fractures were fixed by K-wire s and were followed up for more than one year postoperatively. Bone healing time a nd postoperative complications were recorded. Functions of metacarpophalangeal a nd interphalangeal joints were evaluated using TAF scales. ResultsAccording to TAF scales, excellent and good rate of 82.1% was achieved in cases treated with AO mini-plates, while in cases fixed with K-wires the excellent and good rate w as 70 7%. The difference between the two groups was statistically significant ( P <0 05). There were 19 open fractures of the AO mini-plate group. 3 of the m had infe c tion postoperatively. Among the 29 open fractures of the K-wire group, 5 had in f ections. All the fractures healed. The average duration of bone union was 4.8 we eks for the cases fixed with AO mini-plates, and 7.8 weeks for those fixed with K-wires. ConclusionAccording to comparison of the joint funct ion, postoperativ e infection and duration of bone healing between the two groups, fixation by AO mini-plates is more favorable in treating hand fractures than by using K-wires .