钢板及螺丝钉内固定术与克氏针固定术治疗掌骨干骨折疗效比较

[背景]比较分析掌骨干骨折手术治疗中利用克氏针固定术与钢板及螺丝钉内固定术的疗效.[病例报告]选择2002年3月至2006年3月间因掌骨干骨折而接受手术治疗,术后随访1年以上的58例为研究对象,其中31例为经手法复位或切开复位行克氏针固定术,27例经切开复位行微型钢板及螺丝钉内固定术.多数病例经TAM评级为优良,但5例经手法复位行克氏针固定术的病例及4例经切开复位行克氏针固定术的病例发生背侧成角畸形.[讨论]掌骨干骨折手术中对粉碎性骨折及利用克氏针不能充分固定的骨折患者可选择性地应用微型钢板及螺丝钉内固定术,可达到解剖复位及固定稳定的目的.

Compare of therapeutic effects of miniplate screw fixation and Kirschner wire fixationin for metacarpal shaft fracture

BACKGROUND To compare intramedullary Kirschner wire fixation(KWF) with miniplate screw fixation(MSF) for treatment of metacarpal shaft fracture.CASE REPORTS 58 cases of metacarpal shaft fracture with operative treatment by following up at least 1 year were selected from March,2002 to March,2006.Out of 58 cases of metacarpal shaft fracture,31 cases were carried out with closed reduction and KWF or with open reduction and KWF and 27 cases were treated by open reduction using MSF,and most cases showed either excellent or good results on TAM.5 cases occurred dorsal angulation in closed reduction and KWF group and 4 cases occurred dorsal angulation in open reduction and KWF group,however,no cases of dorsal angulation occured in open reduction and MSF group.DISCUSSION Selective use of MSF in the metacarpal shaft fracture is more effective than KWF in cases of comminuted fracture which can not be achieved firm fixation by KWF.