微型锁定钢板与普通钢板内固定治疗掌指骨骨干骨折的疗效比较

目的：比较微型锁定钢板与普通钢板内固定治疗掌指骨骨干骨折的临床疗效。方法回顾性分析2011年1月至2015年1月本院收治的128例掌指骨骨干骨折患者的临床资料，其中56例采用微型锁定钢板固定（锁定钢板组），72例采用微型普通钢板固定（普通钢板组）。比较两组病例的骨折愈合时间、术后关节功能及总主动屈曲度（tatol active flexion, TAF）情况。结果患者获得随访时间为8~18个月，平均（14.0±2.3）个月。影像学显示锁定钢板组骨折愈合时间为（5.3±3.2）周，普通钢板组为（5.8±2.6）周，两组比较差异无统计学意义（t=0.960，P=0.339）。锁定钢板组术后并发症发生率为7.1%（4/56），普通钢板组为12.5%（9/72），两组比较差异无统计学意义（χ2=0.991，P=0.320）。术后1年随访锁定钢板组的治疗优良率为89.3%，普通钢板组为86.1%，两组比较差异无统计学意义（χ2=0.290，P=0.590）。结论掌指骨骨干骨折采用微型普通或锁定钢板治疗效果满意，且二者疗效无显著差异。但不推荐常规应用锁定钢板固定治疗掌指骨骨干骨折，尤其是简单骨折。

Comparison of mini locking vs. common plate internal fixation in treatment of metacarpal and phalangeal shaft fractures

Objective To compare the clinical effect of internal fixation with mini locking vs. common plate for metacarpal and phalangeal shaft fractures. Methods The clinical data of 128 patients with metacar?pal and phalangeal shaft fractures from January 2011 to January 2015 were retrospectively analyzed, of which 56 cases were treated with mini locking plate and 72 cases with mini common plate. Radiographic bone union time, postoperative complications and tatol active flexion (TAF) scales were recorded and compared. Results The average follow?up was (14.0±2.3) months (8?18 months). Radiographic bone union time in the locking plate group and common plate group was (5.3±3.2) and (5.8±2.6) weeks respectively, with the difference being not sig?nificant between the two groups (t=0.960, P=0.339). The overall rate of postoperative complications was 7.1%in the locking plate group and 12.5%in the common plate group, and the difference between the two groups was not statistically significant (χ2=0.991, P=0.320). According to TAF scales, no statistically significant difference was found in the excellent and good rate between the locking plate group (89.3%) and common plate group (86.1%) 1 year after operation (χ2=0.290, P=0.590). Conclusion Compared with mini locking plate, common plate could achieve the same satisfactory results for patients with metacarpal and phalangeal shaft fractures. It may not be appropriate to treat metacarpal and phalangeal shaft fractures with locking plates, particularly a sim?ple one.