第1掌骨基底部骨折手术治疗疗效分析.docxVIP

第1掌骨基底部骨折手术治疗疗效分析 中国编辑。 作者：王建云，姜世平，唐敏，黄薇 【摘要】 目的 比较不同的手术方法、手术距受伤时间、术后外固定时间的长短对第1掌骨基底部骨折最终疗效的影响。 方法000年1月—XX年10月，手术 治疗2例第1掌骨基底部骨折，其中克氏针固定32例，微型螺钉固定20例，微型钢板固定10例：手术距受伤时间间隔2周者21例；手术后石膏等辅助外固定时间6周者21例。术后随访至内固定物取出后功能康复锻炼无明显进展为止。功能评定采用TAM系统评定法，评定结果分别进行统计学分析。结果 克氏针固定、微型螺钉固定、微型钢板固定术后功能康复优良率分别为％、％、％，三组差异无统计学意义(P)；手术距受伤时间2周术后功能康复优良率分别为%、%，2周内手术组优于2周后手术组(P6周者术后功能康复优良率分别为%、%，术后第1腕掌关节固定6周组明显优于术后外固定6周组(P 【关键词】 第1掌骨基底部；骨折；克氏针；微型螺钉；微型钢板  Abstract： Objective To compare the functional outcomes of different operative approaches. Methods From January000 to October007,cases of base fracture of first metacarpal were treated with fixation by Kirschner wire, micro-plate and micro-screw, respectively. Of a11 the cases,were fixed by Kirschner wire,0 by micro-screw and 10 by micro-plate. There were1 cases whose interval between the beginning of wound and operation was shorter than or equal to two weeks and1 cases whose interval was over two weeks. The external fixation duration was shorter than or equal to six weeks in1 cases, and it was over six weeks in1 cases. Functional outcomes were measured by TAM system and the data were analyzed statistically. Results The good or excellent rates of functional rehabilitation % (by Kirschner wire),5% (by micro-plate), and0% (micro-screw), respectively, among which there were no statistical differances (P). For those whose interval between the beginning of wound and operation was shorter than or equal to two weeks, the good or excellent rate was8%, and for those whose interval was over two weeks, the counterpart %, significantly lower than the former (P Key words： first metacarpal base; frature; Kirschner wire; micro-screw; micro-plate  第1掌骨基底部骨折因其解剖结构的特殊多以手术治疗为主，自XX年1月—XX年10月，我院共手术治疗该骨折64例，手术方法应用闭合或切开复位克氏针固定、切开复位微型螺钉内固定及切开复位微型接骨板内固定等3种方法，现将3种不同治疗方法的最终疗效进行比较并报告如下。  1 资料与方法  一般资料 本组共62例，男49例，女13例，年龄18~39岁，平均26岁，损伤原因：拳击重物致伤14例，跌倒时拇指着地致伤48例，其中有25例为军事训练时摔倒致伤，均为闭合性骨折脱位(其中8例皮肤浅表擦伤，不影响手术安排)，就诊时间