超声与C臂X线机引导闭合复位穿针固定治疗掌指骨骨折的疗效比较

发布时间：2018-05-25 21:31

本文选题：超声检查 + 掌指骨骨折　；参考：《中国修复重建外科杂志》2017年10期

【摘要】：目的对比超声与C臂X线机引导闭合复位穿针固定治疗掌指骨骨折的临床疗效。方法回顾分析2015年10月—2016年11月收治的30例掌指骨骨折患者临床资料,根据治疗方法分为超声组(采用超声引导下闭合复位穿针固定)和C臂X线机组(采用C臂X线机引导闭合复位穿针固定),每组15例。两组患者性别、年龄、病程、致伤原因、受伤指别、伤指部位、骨折分型等一般资料比较差异均无统计学意义(P0.05),具有可比性。评价两组患者骨折复位情况及复位成功率(等级优、良、可者视为复位成功);记录手术时间、术中透视次数、骨折愈合时间;采用中华医学会手外科学会上肢部分功能评定试用标准评估手关节总活动度(total active movement,TAM)恢复情况。结果超声组手术时间多于C臂X线机组,术中透视次数少于C臂X线机组,比较差异均有统计学意义(P0.05);超声组与C臂X线机组间复位等级及复位成功率比较,差异均无统计学意义(P0.05)。两组患者均获随访,随访时间6~18个月,平均10个月。均未出现骨折畸形愈合、关节僵硬、肌腱粘连等并发症。两组骨折愈合时间及TAM等级和优良率比较差异均无统计学意义(P0.05)。结论超声引导闭合复位穿针固定治疗掌指骨骨折效果良好,是一种可行的骨折闭合复位固定治疗辅助方法,且透视次数少,可减少手术放射损害。
[Abstract]:Objective to compare the clinical effect of ultrasound and C-arm X-ray machine-guided closed reduction and needle fixation in the treatment of metacarpal and phalangeal fracture. Methods the clinical data of 30 patients with metacarpal and phalangeal fractures from October 2015 to November 2016 were retrospectively analyzed. According to the treatment method, the patients were divided into two groups: ultrasound group (closed reduction and needle fixation under ultrasonic guidance) and C-arm X-ray unit (15 cases in each group) under the guidance of C-arm X-ray machine. There were no significant differences in sex, age, course of disease, cause of injury, injured finger, injured finger and fracture classification between the two groups (P 0.05). To evaluate the reduction of fracture and the success rate of reduction in the two groups (grade excellent, good, can be regarded as reduction success), the time of operation, the times of fluoroscopy during operation, the time of fracture healing were recorded. Total active movementation (TAM) recovery was evaluated by the evaluation criteria of upper limb function of the Chinese Medical Association. Results the operation time of ultrasound group was longer than that of C-arm X-ray unit, the times of fluoroscopy during operation was less than that of C-arm X-ray unit, the difference was statistically significant (P 0.05), the reduction grade and the success rate of reduction were compared between ultrasound group and C-arm X-ray unit. The difference was not statistically significant (P 0.05). The patients in both groups were followed up for 6 ~ 18 months (mean 10 months). There were no complications such as fracture malunion, joint stiffness, tendon adhesion and so on. There was no significant difference in fracture healing time, TAM grade and excellent and good rate between the two groups (P 0.05). Conclusion Ultrasound-guided closed reduction and needle fixation for metacarpal and phalangeal fractures is a feasible method for the treatment of metacarpal and phalangeal fractures.
【作者单位】：湖南中医药大学;河南省洛阳正骨医院(河南省骨科医院)手显微骨科;
【基金】：2016年度河南省中医药科学研究专项重点课题(2016ZY1011)~~
【分类号】：R658.2

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