微型钢板与克氏针内固定治疗掌指骨骨折的临床比较

目的比较微型钢板与克氏针固定治疗掌指骨骨折的临床效果。方法微型钢板组据骨折部位采用“L”型、“T”型或直钢板固定骨折，钢板置于掌指骨背侧或侧方；克氏针固定组选用交叉克氏针或单根克氏针超关节固定骨折端；肌腱损伤者均一期修复。术后对关节总活动度（TAPS评分标准）、手术时间、住院时间、术后感染及骨折愈合时间进行样本均数比较。结果微型钢板内固定组骨折平均手术时间40min，平均愈合时间7.5周，TAFS评分标准，优良率90.5％；克氏针内固定组平均手术时间25min，平均愈合时间9.1周，TAFS评分标准，714％；两组间术后优良率差异有统计学意义（P〈0.05）。结论微型钢板内固定治疗掌指骨骨折其术后感染率明显降低，且患指的屈伸功能显著改善。

he clinical effect comparision of miniplates and kirschner-wires fixation of metacarpal or phalanx fractures

Objective To compare the clinical effect of mini-nickeclad and Kirschner-wire for fractures of metacarpal and phalanx. Methods “L”,“T”shapes or straight plates were fixed at the dorsal or lateral side of metacarpal or phalanx in miniplates group;crossed Kirschner-wire or single Kirschner-wire were adopted in Kirschner-wire fixation group;all injuried ten- dons were repaired at the same time. We evaluated the total range of motion （TAFS score）, operating time, hospital rime,infection rate and time of fractures union in both groups. Results In miniplates fixation group,the mean operating times is 40 minutes, mean hospital time is 5. 3 days, mean rate of wound infection is 2.4%. in Kirschner-wire group, the mean operating time is 25 minutes, mean hospital time is 4.8days, mean rate of wound infection is 20%, mean time of fractures union is 9 weeks, and by TAFS score rate of fineness is 71.4%. The data of rate of wound infection and TAFS score of fineness shows statistical difference. Conclusion The miniplates decrease the rate of wound infection, and improve the movement range of involved finger.