两种内固定方法治疗掌指骨骨折的疗效分析

目的比较采用克氏针内固定和微型钛板治疗掌、指骨骨折的临床效果。方法克氏针内固定治疗组42例45处骨折,术后随访1.5～12个月,平均8.4个月;微型钛板内固定治疗组28例36处骨折,术后随访2～12个月,平均9.2个月。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。结果克氏针固定组优良率为68.9%,微型钛板固定组优良率为80.6%,克氏针固定组与微型钛板组差异有显著意义(P<0.05)。克氏针组33处开放性骨折中5处发生感染;微型钛板组26处开放性骨折中3处发生感染。骨折愈合时间微型钛板组为7～12周,平均8.1周;克氏针组为6～12周,平均7.8周。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,微型钛板组的疗效明显优于克氏针组,克氏针组骨折愈合时间较前者短。

Therapeutic analysis of metacarpal and phalanges fractures fixed by two methods

Objective To compare the clinical results of metacarpal and phalanges fractures which were fixed with K-wires and Titanium mini-plate respectively.Methods 42 cases with 45 metacarpal or phalanges fractures were fixed by K-wires and were followed up for 8.4 months on average(range 1.5-12 months).28 cases with 36 metacarpal or phalanges fractures were treated with Titanium mini-plates.Following-up for this group was 9.2 months on average(range 2-12 months).Bone healing time and postoperative complications were recorded.Functions of metacarpal-phalanges inter-phalanges joints were evaluated using TAFS scales.Results According to TAFS scale,excellent and good rate of 68.9% was achieved in cases fixed with K-wires,while in cases treated with Titanium mini-plates the excellent and good rate were 80.6%.The differences between them were statistically significant(P <0.05).Among the 33 open fractures of the K-wire group,5 had infections.There were 26 open fractures of the Titanium mini-plate group,3 of them had infection postoperatively.All the fractures healed.The average duration of the bone union was 8.1 weeks for the cases fixed with Titanium mini-plate and 7.8 weeks for those fixed with K-wires.Conclusion According to comparison of the joint function and postoperative infection between the two groups,fixation by Titanium mini-plates are more favorable in treating hand fractures than by using K-wires.But the duration of bone healing of the cases fixed with K-wire is short than the former.