[1]程省,汤立新,赵玉果,等.切开复位空心钉内固定与闭合复位经皮克氏针内固定治疗GeddaⅠ型Bennett骨折的比较研究[J].中医正骨,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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切开复位空心钉内固定与闭合复位经皮克氏针内固定治疗GeddaⅠ型Bennett骨折的比较研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年09期
页码:
20-24
栏目:
临床研究
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; 汤立新; 赵玉果; 马远; 王华磊; 叶向阳; 李显博; 郭雄飞
(南阳市中心医院,河南 南阳 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
关键词:
骨折固定术; 内;  骨螺丝;  克氏针;  治疗结果;  Bennett骨折
Keywords:
fracture fixation; internal;  bone screws;  Kirschner wires;  treatment outcome;  Bennett fracture
摘要:
目的:比较切开复位空心钉内固定与闭合复位经皮克氏针内固定治疗GeddaⅠ型Bennett骨折的临床疗效和安全性。方法:回顾性分析49例GeddaⅠ型Bennett骨折患者的病例资料,接受切开复位空心钉内固定治疗者24例(空心钉组),接受闭合复位经皮克氏针内固定治疗者25例(克氏针组)。比较2组患者的骨折愈合时间、术后并发症发生率,以及术后3个月、术后1年的上肢功能障碍(disabilities of the arm,shoulder and hand,DASH)评分和患手疼痛视觉模拟量表(visual analogue scale,VAS)评分。结果:2组患者骨折愈合时间、术后3个月和术后1年患手疼痛VAS评分、术后1年DASH评分比较,组间差异均无统计学意义[(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]; 术后3个月空心钉组的DASH评分低于克氏针组[(15.32±3.23)分,(25.25±7.81)分,t=5.740,P=0.000]。空心钉组术后并发局部皮肤感觉异常2例(1例为麻木,1例为刺痛),均未行特殊处理,末次随访时症状有所改善。克氏针组术后并发克氏针松动、复位丢失2例,再次行闭合复位克氏针内固定手术后骨折愈合; 并发针道感染1例,抗感染治疗后感染控制,骨折愈合后去除克氏针。均无骨折延迟愈合、不愈合、畸形愈合及神经、血管损伤等并发症发生。2组患者并发症发生率的差异无统计学意义(χ2=0.000,P=1.000)。结论:切开复位空心钉内固定与闭合复位经皮克氏针内固定治疗GeddaⅠ型Bennett骨折,二者在缓解患手疼痛、促进骨折愈合方面疗效相当,且安全性相当,但前者在促进术后早期上肢功能恢复方面有优势。
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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备注/Memo

备注/Memo:
通讯作者:汤立新 E-mail:tlxin@126.com
更新日期/Last Update: 1900-01-01