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[1]程省,趙玉果,馬遠,等.切開復位空心螺釘內(nèi)固定與克氏針內(nèi)固定治療尺骨莖突基底部骨折的對比研究[J].中醫(yī)正骨,2020,32(09):23-27.
　CHENG Sheng,ZHAO Yuguo,MA Yuan,et al.A comparative study of open reduction and hollow screw internal fixation versus open reduction and Kirschner wire internal fixation for treatment of ulnar styloid base fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(09):23-27.
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切開復位空心螺釘內(nèi)固定與克氏針內(nèi)固定治療尺骨莖突基底部骨折的對比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年09期
頁碼:
23-27
欄目:
臨床研究
出版日期:
2020-09-20

文章信息/Info

Title:
A comparative study of open reduction and hollow screw internal fixation versus open reduction and Kirschner wire internal fixation for treatment of ulnar styloid base fractures
作者:
程省; 趙玉果; 馬遠; 葉向陽; 湯立新; 李顯博
(南陽市中心醫(yī)院,河南 南陽 473003)
Author(s):
CHENG Sheng; ZHAO Yuguo; MA Yuan; YE Xiangyang; TANG Lixin; LI Xianbo
Nanyang Central Hospital,Nanyang 473003,Henan,China
關(guān)鍵詞:
尺骨骨折;  骨折固定術(shù); 內(nèi);  尺骨莖突;  克氏針;  空心螺釘;  對比研究
Keywords:
ulna fractures;  fracture fixation; internal;  styloid process of ulna;  Kirschner wire;  hollow screw;  comparative study
摘要:
目的:比較切開復位空心螺釘內(nèi)固定與切開復位克氏針內(nèi)固定治療尺骨莖突基底部骨折的臨床療效和安全性。方法:回顧性分析104例尺骨莖突基底部骨折患者的病例資料,其中采用切開復位空心螺釘內(nèi)固定治療42例(空心螺釘內(nèi)固定組),采用切開復位克氏針內(nèi)固定治療62例(克氏針內(nèi)固定組)。比較2組患者的骨折愈合率、Cooney腕關(guān)節(jié)評分、腕關(guān)節(jié)旋轉(zhuǎn)疼痛發(fā)生率及并發(fā)癥發(fā)生率。結(jié)果:所有患者均獲得隨訪,隨訪時間12～36個月,中位數(shù)18個月。切口均甲級愈合。術(shù)后12個月,空心螺釘內(nèi)固定組骨折愈合率、Cooney腕關(guān)節(jié)評分均高于克氏針內(nèi)固定組[χ2=6.674,P=0.010;(91.27±6.52)分,(85.32±4.62)分,t=2.530,P=0.014]; 2組患者腕關(guān)節(jié)旋轉(zhuǎn)疼痛發(fā)生率比較,差異無統(tǒng)計學意義(χ2=3.296,P=0.069)。克氏針內(nèi)固定組5例發(fā)生克氏針退針; 其中3例克氏針松動導致腕部疼痛明顯,提前取出克氏針后腕部疼痛顯著減輕; 2例腕部疼痛較輕,未予以特殊處理,術(shù)后12個月常規(guī)取出克氏針后腕部疼痛消失。空心螺釘內(nèi)固定組患者未發(fā)生螺釘松動。2組患者均未發(fā)生神經(jīng)血管損傷、骨折復位丟失等并發(fā)癥。2組患者并發(fā)癥發(fā)生率比較,差異無統(tǒng)計學意義(χ2=3.558,P=0.059)。結(jié)論:采用切開復位空心螺釘內(nèi)固定治療尺骨莖突基底部骨折相較于切開復位克氏針內(nèi)固定,更有利于骨折愈合和腕關(guān)節(jié)功能恢復,二者的安全性相當。
Abstract:
To compare the clinical curative effects and safety of open reduction and hollow screw internal fixation versus open reduction and Kirschner wire internal fixation for treatment of ulnar styloid base fractures.Methods:The medical records of 104 patients with ulnar styloid base fractures were analyzed retrospectively.Forty-two patients were treated with open reduction and hollow screw internal fixation(group A),while the others were treated with open reduction and Kirschner wire internal fixation(group B).The fracture healing rate,Cooney wrist score,wrist rotation pain incidence and complication incidence were compared between the 2 groups.Results:All patients in the 2 groups were followed up for 12-36 months with a median of 18 months and all patients in the 2 groups got primary healing in the surgical incisions.At 12 months after the surgery,the fracture healing rate and Cooney wrist scores were higher in group A compared to group B(χ2=6.674,P=0.010; 91.27+/-6.52 vs 85.32+/-4.62 points,t=2.530,P=0.014).There was no statistical difference in wrist rotation pain incidence between the 2 groups(χ2=3.296,P=0.069).The Kirschner wire withdrawal was found in 5 patients in group B,in which obvious and mild wrist pains were found in 3 and 2 patients respectively.The obvious wrist pains of the 3 patients were significantly alleviated after the Kirschner wire was removed in advance,while no special treatment was performed on the 2 patients with mild wrist pains and the pain disappeared after the Kirschner wire was routinely removed at 12 months after the surgery.No screw loosening was found in group A.No complications such as neurovascular injury and fracture reduction loss were found in the 2 groups.There was no statistical difference in complication incidences between the 2 groups(χ2=3.558,P=0.059).Conclusion:Open reduction and hollow screw internal fixation is more conducive to the fracture healing and wrist function recovery compared to open reduction and Kirschner wire internal fixation in treatment of ulnar styloid base fractures,while they are similar to each other in safety.

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通訊作者:湯立新 E-mail:[email protected]
更新日期/Last Update: 2020-09-20