指掌骨骨折合并软组织损伤的微型锁定钢板皮外固定应用效果及对关节活动度的影响

目的 探讨微型锁定钢板皮外固定应用于指掌骨骨折合并软组织损伤患者中的治疗效果及其对关节活动度的影响。方法 选取指掌骨合并软组织损伤的患者60例为研究对象,随机分为对照组（30例）和观察组（30例）。对照组实施常规固定手术,观察组实施微型锁定钢板皮外固定,并依照患者软组织损伤实际情况采取石膏进行外固定。术后对比两组患者骨折愈合时间、围术期指标、Jamar握力、总关节活动度（total angle of motion,TAM）、上肢功能评定（disabilities of the arm,shoulder and hand,DASH）、术后不良反应情况及生活质量。结果 两组患者手术时间比较差异无统计学意义（P>0.05）,观察组患者骨折愈合时间、住院时间和DASH评分低于对照组（P<0.05）,TAM评分、生活质量评分和Jamar握力高于对照组（P<0.05）。观察组不良反应发生率（0.67%）低于对照组（33.33%,P<0.05）。结论 采取微型锁定钢板皮外固定方式对指掌骨骨折合并软组织损伤进行治疗,再采取石膏进行外固定,虽然增加患者的手术时间,但是能够减少患者骨折愈合时间,安全性较高,另外能够更好地促进患者恢复关节功能,提升患者生活质量。

Application effect of mini locking plate external fixation for metacarpal fracture with soft tissue injury and its influence on joint range of motion

Objective To investigate the effect of external fixation of the mini-locking steel plate for digit metacarpal fractures combined with soft tissue injuries and its influence on joint range of motion.Methods A total of 60 patients with metacarpal bone and soft tissue injury were selected as the subjects of this study. 60 patients were randomly divided into control group and observation group, 30 cases in each group. The patients in the control group were received routine fixation. On the basis of the control group, the patients in the observation group were treated with micro-locking plate external fixation combined with external fixation, and plaster external fixation was applied for the patients with soft tissue injury. The fracture healing time and perioperative indexes, Jamar grip strength, total angle of motion（TAM） and disabilities of the arm,shoulder and hand（DASH） scores, postoperative adverse reactions and quality of life were compared between the two groups.Results There was no significant difference in the operation time between the two groups （P>0.05）. The fracture healing time, hospitalization time and DASH score of patients in the observation group were lower than those in the control group （P<0.05）, and TAM score, quality of life score and Jamar grip strength were higher than those in the control group （P<0.05）. The incidence of adverse reactions in the observation group （0.67%） was lower than that in the control group （33.33%, P<0.05）.Conclusion On the basis of conventional Kirschner wire internal fixation, micro locking plate external fixation combined with plaster fixation can increase the operation steps and operation time, but it is more conducive to the fracture healing, reduce the occurrence of adverse reactions, reduce the length of hospital stay, and promote the recovery of joint function after discharge. It is worthy of clinical application and promotion to improve the quality of life.