第五掌骨远端骨折不同手术方式疗效比较.docVIP

第五掌骨远端骨折不同手术方式疗效比较 韦健 洪定钢 广西医科大学附属柳铁中心医院关节骨科 广西中医药大学第三附属医院骨一科 X 关注成功！ 加关注后您将方便地在 我的关注中得到本文献的被引频次变化的通知！ 新浪微博 腾讯微博 人人网 开心网 豆瓣网 网易微博 摘????要： 目的 对比分析第五掌骨远端骨折不同手术方式的疗效。方法 选取广西中医药大学第三附属医院骨科2009年4月—2015年4月手第五掌骨远端骨折40例, 其中男性33例, 女性7例;年龄1750岁, 平均27.4岁;致伤原因:拳击伤30例, 摔伤4例, 道路交通伤6例;受伤至手术时间1h6d。采取数字表法随机分为3组, 采取髓内针固定14例 (A组) , 第四、五掌骨改良克氏针外固定架固定12例 (B组) , 钢板螺钉内固定14例 (C组) , 比较3组内固定方式的手术时间、骨折复位程度、骨折愈合时间、术后4个月第五掌骨头干角、掌指关节功能。结果 所有病例骨折均获得愈合, 无感染及皮肤坏死。A组在手术时间[ (36±4) min]、骨折愈合时间[ (11±2) 周]、掌指关节功能[ (86.2±4.4) °]及并发症发生方面均优于B组[ (34±6) min, (12±2) 周, (83.8±3.5) °]及C组[ (43±3) min, (14±3) 周, (80.1±4.8) °]。结论 髓内针内固定治疗第五掌骨远端骨折, 可以尽早恢复关节功能, 值得临床推广。 关键词： 掌骨远端骨折; 内固定; 螺钉; 髓内针; 外固定; 作者简介：洪定钢, E-mail:150028151@ 收稿日期：2016-08-07 Comparison of therapeutic effects of different surgical methods in the fifth distal metacarpal fractures WEI Jian HONG Ding-gang Department of Joint Orthopedics, Liuzhou Railway Central Hospital Affiliated to Guangxi Medical University; Third Affiliated Hospital of Guangxi University of Traditional Chinese Medicine; Abstract： Objective To compare and analyze the effect of different surgical approaches for the fifth distal metacarpal fractures. Methods Forty cases of the fifth distal metacarpal fractures were selected, who were treated in Department of Orthopedics, Affiliated Hospital of the Third Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from Apr. 2009 to Apr. 2015. There were 33 males and 7 females, with an average age of 27. 4 years ( range, 17 to 50 years) . The injury causes included 30 cases of boxing, 4 cases of falls, and 6 cases of road traffic injury; the time from injury to surgery was 1 h to 6 d. Patients were randomly divided into 3 groups: 14 cases of intramedullary nail fixation ( group A) , 12 cases of the fourth, fifth metacarpal Kirschner wire external fixation ( group B) , and 14 cases of plate fixation ( group C) . The operation time, fracture reduction degree, fracture healing time and the fifth metacarpal head