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[1]程省,湯立新,趙玉果,等.切開復(fù)位空心釘內(nèi)固定與閉合復(fù)位經(jīng)皮克氏針內(nèi)固定治療GeddaⅠ型Bennett骨折的比較研究[J].中醫(yī)正骨,2021,33(09):20-24.
　CHENG Sheng,TANG Lixin,ZHAO Yuguo,et al.A comparative study of open reduction and hollow screws internal fixation versus closed reduction and percutaneous Kirschner wires internal fixation for treatment of Gedda typeⅠBennett fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(09):20-24.
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切開復(fù)位空心釘內(nèi)固定與閉合復(fù)位經(jīng)皮克氏針內(nèi)固定治療GeddaⅠ型Bennett骨折的比較研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期數(shù):
2021年09期
頁(yè)碼:
20-24
欄目:
臨床研究
出版日期:
2021-09-20

文章信息/Info

Title:
A comparative study of open reduction and hollow screws internal fixation versus closed reduction and percutaneous Kirschner wires internal fixation for treatment of Gedda typeⅠBennett fractures
作者:
程省; 湯立新; 趙玉果; 馬遠(yuǎn); 王華磊; 葉向陽(yáng); 李顯博; 郭雄飛
(南陽(yáng)市中心醫(yī)院,河南 南陽(yáng) 473003)
Author(s):
CHENG Sheng; TANG Lixin; ZHAO Yuguo; MA Yuan; WANG Hualei; YE Xiangyang; LI Xianbo; GUO Xiongfei
Nanyang Central Hospital,Nanyang 473003,Henan,China
關(guān)鍵詞:
骨折固定術(shù); 內(nèi);  骨螺絲;  克氏針;  治療結(jié)果;  Bennett骨折
Keywords:
fracture fixation; internal;  bone screws;  Kirschner wires;  treatment outcome;  Bennett fracture
摘要:
目的:比較切開復(fù)位空心釘內(nèi)固定與閉合復(fù)位經(jīng)皮克氏針內(nèi)固定治療GeddaⅠ型Bennett骨折的臨床療效和安全性。方法:回顧性分析49例GeddaⅠ型Bennett骨折患者的病例資料,接受切開復(fù)位空心釘內(nèi)固定治療者24例(空心釘組),接受閉合復(fù)位經(jīng)皮克氏針內(nèi)固定治療者25例(克氏針組)。比較2組患者的骨折愈合時(shí)間、術(shù)后并發(fā)癥發(fā)生率,以及術(shù)后3個(gè)月、術(shù)后1年的上肢功能障礙(disabilities of the arm,shoulder and hand,DASH)評(píng)分和患手疼痛視覺模擬量表(visual analogue scale,VAS)評(píng)分。結(jié)果:2組患者骨折愈合時(shí)間、術(shù)后3個(gè)月和術(shù)后1年患手疼痛VAS評(píng)分、術(shù)后1年DASH評(píng)分比較,組間差異均無統(tǒng)計(jì)學(xué)意義[(6.23±3.25)周,(5.56±2.27)周,t=0.816,P=0.419;(3.34±2.23)分,(2.25±2.55)分,t=1.562,P=0.125;(1.21±1.03)分,(1.08±1.98)分,t=0.284,P=0.778;(8.21±2.32)分,(9.30±3.74)分,t=1.206,P=0.234]; 術(shù)后3個(gè)月空心釘組的DASH評(píng)分低于克氏針組[(15.32±3.23)分,(25.25±7.81)分,t=5.740,P=0.000]。空心釘組術(shù)后并發(fā)局部皮膚感覺異常2例(1例為麻木,1例為刺痛),均未行特殊處理,末次隨訪時(shí)癥狀有所改善。克氏針組術(shù)后并發(fā)克氏針?biāo)蓜?dòng)、復(fù)位丟失2例,再次行閉合復(fù)位克氏針內(nèi)固定手術(shù)后骨折愈合; 并發(fā)針道感染1例,抗感染治療后感染控制,骨折愈合后去除克氏針。均無骨折延遲愈合、不愈合、畸形愈合及神經(jīng)、血管損傷等并發(fā)癥發(fā)生。2組患者并發(fā)癥發(fā)生率的差異無統(tǒng)計(jì)學(xué)意義(χ2=0.000,P=1.000)。結(jié)論:切開復(fù)位空心釘內(nèi)固定與閉合復(fù)位經(jīng)皮克氏針內(nèi)固定治療GeddaⅠ型Bennett骨折,二者在緩解患手疼痛、促進(jìn)骨折愈合方面療效相當(dāng),且安全性相當(dāng),但前者在促進(jìn)術(shù)后早期上肢功能恢復(fù)方面有優(yōu)勢(shì)。
Abstract:
Objective:To compare the clinical curative effects and safety of open reduction and hollow screws internal fixation versus closed reduction and percutaneous Kirschner-wires(K-wires)internal fixation in treatment of Gedda typeⅠBennett fractures.Methods:The medical records of 49 patients with Gedda typeⅠBennett fractures were analyzed retrospectively.Twenty-four patients were treated with open reduction and hollow screws internal fixation(hollow screw group),while the others with closed reduction and percutaneous K-wires internal fixation(K-wire group).The fracture healing time,postoperative complication incidence,disabilities of the arm,shoulder and hand(DASH)scores and injured hand pain visual analogue scale(VAS)scores at 3 and 12 months after the surgery were compared between the 2 groups.Results:There was no statistical difference in fracture healing time,injured hand pain VAS scores at 3 and 12 months after the surgery and DASH scores at 12 months after the surgery between the 2 groups(6.23±3.25 vs 5.56±2.27 weeks,t=0.816,P=0.419; 3.34±2.23 vs 2.25±2.55 points,t=1.562,P=0.125; 1.21±1.03 vs 1.08±1.98 points,t=0.284,P=0.778; 8.21±2.32 vs 9.30±3.74 points,t=1.206,P=0.234).The DASH scores were lower in hollow screw group compared to K-wire group at 3 months after the surgery(15.32±3.23 vs 25.25±7.81 points,t=5.740,P=0.000).The postoperative local skin paresthesia,manifesting as numbness in 1 patient and stabbing pain in 1 patient,were found in hollow screw group,and the symptoms improved spontaneously at last follow-up without any special treatment.The postoperative K-wires loosening and fracture reduction loss(2 cases)as well as pin hole infection(1 case)were found in K-wire group.The fractures healed after closed reduction and percutaneous K-wires internal fixation,and the infection was controlled after anti-infection treatment and the K-wires were removed after fracture healing.No complications such as fracture delayed union,fracture nonunion,fracture malunion and neurovascular injury were found in the 2 groups.There was no statistical difference in complication incidences between the 2 groups(χ2=0.000,P=1.000).Conclusion:The open reduction and hollow screws internal fixation is similar to closed reduction and percutaneous K-wires internal fixation in safety and curative effects on relieving injured hand pain and promoting fracture healing in treatment of Gedda typeⅠBennett fractures,while the former has advantages in promoting postoperative early upper limbs function recovery compared to the latter.

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通訊作者:湯立新 E-mail:[email protected]
更新日期/Last Update: 1900-01-01