非拇指掌骨关节外干骨折的治疗:钢板螺钉固定与k针固定。

IF 1.4 Q3 EMERGENCY MEDICINE International Journal of Burns and Trauma Pub Date : 2021-10-15 eCollection Date: 2021-01-01
Ved Prakash Rao Cheruvu, Sunil Gaba, Jerry R John, Sourabh Rawat
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引用次数: 0

摘要

掌骨骨折是一种常见的损伤,占手部所有骨折的36%至42%。其中大多数可以非手术治疗。需要时可采用多种技术进行手术固定。在本研究中,我们比较了两种技术,钢板螺钉固定和k针固定的结果。我们进行了一项前瞻性、非随机、比较研究,研究对象是在18个月的时间里出现非拇指掌骨关节外掌骨干骨折的患者。30例患者按照纳入标准入组,交替分为钢板螺钉组和k线组。入院时,记录患者人口统计学、临床特征、骨折数量和骨折类型,并拍摄x线片。钢板-螺钉组采用低轮廓钢板和螺钉,k -丝组骨折复位后采用1或2枚k -丝固定。钢板-螺钉组在术后1周内开始进行手部活动练习,而k线组在术后4周开始完全活动。计算两组患者术后6个月和12个月的臂肩手功能障碍(DASH)评分并进行比较。钢板螺钉组平均6个月DASH评分为6.3287±2.2453,k线组平均6个月DASH评分为17.1627±6.2103 (p值=0.848)。综上所述,经钢板螺钉固定治疗的非拇指掌骨关节外干骨折患者在6个月时DASH评分明显提高,功能预后也较好。然而,在1年结束时,两组的DASH评分几乎相似,表明长期功能结果相似。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Management of extra-articular shaft fractures of the non-thumb metacarpals: plate-screw fixation versus K-wire fixation.

Metacarpal fractures are common injuries and comprise nearly 36% to 42% of all fractures in the hand. The majority of these can be managed non-surgically. Operative fixation when needed, can be done by a variety of techniques. In this study, we have compared the outcomes of two techniques, plate-screw fixation and K-wire fixation. We have conducted a prospective, non-randomized, comparative study of patients who presented with extra-articular metacarpal shaft fractures of non-thumb metacarpals over a period of 18 months. 30 patients were enrolled according to the inclusion criteria and were alternately allotted to the plate-screw group and the K-wire group. At admission, patient demographics, clinical features, number of fractures, and fracture patterns were recorded, and radiographs were taken. In the plate-screw group, low-profile plates and screws were used, and in the K-wire group, 1 or 2 K-wires were used for fixation after fracture reduction. Hand mobilization exercises were started within one week in the plate-screw group, while in the K-wire group full mobilization was allowed at 4 weeks post-surgery. The Disabilities of Arm, Shoulder and Hand (DASH) score was calculated and compared between the two groups at 6 months and 12 months after surgery. The mean 6-month DASH score in the plate-screw group was 6.3287±2.2453, while it was 17.1627±6.2103 in the K-wire group (p value <0.001). At the end of 1-year follow-up, the mean DASH score in the plate-screw group was 5.1080±1.6637, and in the K-wire group, it was 5.1073±1.9392 (p value =0.848). In conclusion, extra-articular metacarpal shaft fractures of the non-thumb metacarpals treated by plate-screw fixation had significantly better DASH scores and hence better functional outcomes at the end of 6 months. However, at the end of 1 year, the DASH scores in both the groups were almost similar, suggesting similar functional outcomes in the long term.

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