实用临床医学
實用臨床醫學
실용림상의학
Practical Clinical Medicine
2014年
12期
40-42
,共3页
撕脱性骨折%锤状指%伸肌腱%克氏针%骨锚
撕脫性骨摺%錘狀指%伸肌腱%剋氏針%骨錨
시탈성골절%추상지%신기건%극씨침%골묘
avulsion fracture%mallet finger%extensor tendon%Kirschner%bone anchor
目的:观察比较克氏针挤压复位固定与微型骨锚治疗骨性锤状指的临床疗效。方法收集2010年3月至2013年8月所有末节指骨撕脱性骨折并接受手术治疗的患者48例51指,所有患者按随机数字表法分成A、B 2组, A 组(24例25指)采用克氏针挤压复位固定骨折块治疗;B 组(24例26指)采用微型骨锚重建指伸肌腱I区止点,均随访3~6个月,按TAM 系统方法评定治疗效果。结果 A 组24例25指,随访23指,平均随访116 d,按TAM 系统评定方法,优14指,良6指,可2指,差1指,优良率86.96%。 B 组24例26指,随访24指,平均随访108 d,按TAM 系统评定方法,优13例,良9例,可1例,差1例,优良率84.62%。2组功能优良率差异无统计学意义(P>0.05)。 A组2例出现术后并发症,并发症发生率8.70%,B组6例出现术后并发症,并发症发生率为20.83%,A组术后并发症发生率明显低于B组(P<0.05)。结论克氏针挤压复位固定法临床疗效可靠,并发症少,手术费用低。
目的:觀察比較剋氏針擠壓複位固定與微型骨錨治療骨性錘狀指的臨床療效。方法收集2010年3月至2013年8月所有末節指骨撕脫性骨摺併接受手術治療的患者48例51指,所有患者按隨機數字錶法分成A、B 2組, A 組(24例25指)採用剋氏針擠壓複位固定骨摺塊治療;B 組(24例26指)採用微型骨錨重建指伸肌腱I區止點,均隨訪3~6箇月,按TAM 繫統方法評定治療效果。結果 A 組24例25指,隨訪23指,平均隨訪116 d,按TAM 繫統評定方法,優14指,良6指,可2指,差1指,優良率86.96%。 B 組24例26指,隨訪24指,平均隨訪108 d,按TAM 繫統評定方法,優13例,良9例,可1例,差1例,優良率84.62%。2組功能優良率差異無統計學意義(P>0.05)。 A組2例齣現術後併髮癥,併髮癥髮生率8.70%,B組6例齣現術後併髮癥,併髮癥髮生率為20.83%,A組術後併髮癥髮生率明顯低于B組(P<0.05)。結論剋氏針擠壓複位固定法臨床療效可靠,併髮癥少,手術費用低。
목적:관찰비교극씨침제압복위고정여미형골묘치료골성추상지적림상료효。방법수집2010년3월지2013년8월소유말절지골시탈성골절병접수수술치료적환자48례51지,소유환자안수궤수자표법분성A、B 2조, A 조(24례25지)채용극씨침제압복위고정골절괴치료;B 조(24례26지)채용미형골묘중건지신기건I구지점,균수방3~6개월,안TAM 계통방법평정치료효과。결과 A 조24례25지,수방23지,평균수방116 d,안TAM 계통평정방법,우14지,량6지,가2지,차1지,우량솔86.96%。 B 조24례26지,수방24지,평균수방108 d,안TAM 계통평정방법,우13례,량9례,가1례,차1례,우량솔84.62%。2조공능우량솔차이무통계학의의(P>0.05)。 A조2례출현술후병발증,병발증발생솔8.70%,B조6례출현술후병발증,병발증발생솔위20.83%,A조술후병발증발생솔명현저우B조(P<0.05)。결론극씨침제압복위고정법림상료효가고,병발증소,수술비용저。
Objective To compare the clinical efficacy of Kirschner wire fixation and miniature bone anchor in the treatment of mallet fingers. Methods Forty-eighty patients who received operation for the avulsion fracture of the distal phalanx (51 fingers) between March 2010 and August 2013 were randomly divided into two groups. The group A (24 patients, 25 fingers) was treated with Kirschner wire fixation. The group B (24 patients, 26 fingers) was treated with the reconstruction of terminal extensor tendon with miniature bone anchor. All patients were followed up for 3-6 months and the curative efficacies were evaluated by using TAM system. Results In group A, 23 fingers were followed up for an average of 116 days. According to TAM system, the function was excellent in 14 fingers, good in 6, fair in 2 and poor in 1. In group B, 24 fingers were followed up for an average of 108 days. According to TAM system, the function was excellent in 13 fingers, good in 9, fair in 1 and poor in 1. The choiceness rate was 86.96% in group A and 84.62% in group B. There was no significant difference in the choiceness rate between the two groups (P>0.05). However, the incidence of postoperative complications in group A (8.70%, 2 patients) was significantly lower than that in group B(20.83%, 6 patients)(P<0.05). Conclusion Kirschner wire fixation is reliable for treating mallet fingers and allows few complications and low costs.