可吸收棒和微型接骨板内固定治疗掌骨斜形骨折的疗效比较

发布时间：2018-03-05 08:53

本文选题：可吸收棒　切入点：微型接骨板　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:比较可吸收棒与微型接骨板治疗掌骨斜形骨折的临床疗效。方法:总共80例95处掌骨斜形骨折的患者,分为可吸收棒内固定组(A组,29例31处)和微型接骨板内固定组(B组,51例64处)。所有病例均为闭合性掌骨斜形骨折患者,无明显手术禁忌,排除病理性骨折及炎症、感染或对植入材料过敏的病人。全部患者都在臂丛麻醉及止血带下手术。分别采取微型接骨板和可吸收棒内固定治疗。要求术中骨折断端达到解剖复位,经C臂透视下观察复位满意,然后冲洗创面并逐层缝合切口。手术过程中注意保护腱周组织,减轻术后肌腱粘连,术后随访时间为1~12个月(平均6.5个月)。对术后手功能恢复评价标准,我们采纳美国手外科协会评分(TAFS)标准。记录指间关节以及掌指关节活动度,两组记录所得数据结果进行统计学分析处理采用SPSS19.0软件,计数资料采取χ2检验,计量资料采取t检验。结果:所有骨折均达到骨性愈合。术后都未出现内固定物松动、感染及皮肤过敏等情况,两组所纳入病例也未出现掌骨骨折延迟愈合或不愈合情况。按照美国手外科协会评分标准,微型钢板51例(64处)骨折中,优31处,良25处,差8处,优良率87.5%;可吸收棒组29例(31处)骨折中,优19处,良11处,差1处,优良率96.7%,两组间优良率无显著差异(P0.05)。结论:可吸收棒固定强度能达到手术治疗要求,治疗掌骨斜形骨折操作方便简单,无异物感及应力遮挡,避免再次手术,无影像干扰,组织相容性好,是一种理想并且有效的治疗方法。
[Abstract]:Objective: to compare the clinical efficacy of absorbable rod and microplate in the treatment of oblique metacarpal fractures. They were divided into absorbable rod fixation group (n = 29, n = 31) and microplate fixation group (n = 51, n = 64). All cases were closed oblique metacarpal fractures. All patients were operated under brachial plexus anesthesia and tourniquet. Microplate and absorbable rod fixation were performed respectively. Satisfactory reduction was observed by C-arm fluoroscopy, then wound was flushed and wound was sutured layer by layer. Attention was paid to the protection of peritendinous tissue during operation, and to the reduction of tendon adhesion after operation. The follow-up time was 1 ~ 12 months (mean 6.5 months). For the evaluation criteria of postoperative hand function recovery, we adopted the TAFS standard to record the movement of interphalangeal and metacarpophalangeal joints, and recorded the movement of interphalangeal joints and metacarpophalangeal joints. The data of the two groups were analyzed statistically by SPSS19.0 software. The count data were analyzed by 蠂 2 test and the measurement data by t test. Results: all the fractures were bony healed. No internal fixation loosening was found after operation. Infection and skin allergy were not found in the two groups. According to the American Society of hand surgery (AHSA) scoring standard, 64 cases of mini-plate fractures were excellent in 31 cases, good in 25 cases, and poor in 8 cases. The excellent and good rate was 87.5%, the absorbable rod group was 29 cases with 31 fractures, excellent 19, good 11, poor 1, excellent and good rate 96.77.There was no significant difference in excellent and good rate between the two groups (P 0.05). Conclusion: the strength of absorbable rod fixation can meet the requirement of surgical treatment. The treatment of oblique fracture of metacarpal bone is an ideal and effective method for treatment of oblique fracture of metacarpal with simple operation, no foreign body sensation and stress occlusion, no reoperation, no image interference and good histocompatibility.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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