摘要
目的:探讨采用自制顺解剖结构塔形垫结合夹板石膏固定治疗不稳定型第2-5掌骨骨折,分析治疗后的效果,以期为临床治疗方法提供依据。方法:回顾性分析自2019年1月至2022年12月采用自制顺解剖结构塔形垫结合夹板石膏固定治疗不稳定型第2-5掌骨骨折患者共98例,其中男74例,女24例,年龄19~63(41.58±7.23)岁。观察治疗效果,采用总主动活动度(total active movement,TAM)评分标准对掌指关节活动功能评价,总结并发症发生及骨折愈合情况。结果:所有患者获得随访,时间1~5(3.45±1.03)个月。解剖对位患者75例,解除固定仍维持解剖对位患者68例;功能对位患者23例,解除固定仍维持功能对位患者20例;复位后发生移位患者10例。骨折愈合时间(5.78±1.14)周,骨折愈合良好,未出现角畸形或旋转畸形。治疗后3个月采用TAM评分标准对患者的手功能进行评价,患者的掌指关节背伸活动度(10.72±1.35)°与屈曲活动度(83.19±4.08)°,优于治疗前(8.25±0.68)°、(70.35±2.36)°,差异有统计学意义(P<0.05)。98例患者最终手TAM评测结果:优92例,良5例,可1例。结论:针对不稳定型第2-5掌骨骨折患者,实施自制顺解剖结构塔形垫固定治疗的效果确切。
Objective To evaluate the clinical efficacy of self-made anatomical tower-shaped pads combined with splint plaster fixation in the treatment of unstable 2nd to 5th metacarpal fractures and to provide a reference for clinical practice.Methods A retrospective analysis was conducted on 98 patients with unstable 2nd to 5th metacarpal fractures treated with self-made anatomical tower-shaped pads combined with splint plaster fixation between January 2019 and December 2022.There were 74 males and 24 females,aged from 19 to 63 years old with an average of(41.58±7.23)years old.The total active movement(TAM)score was used to evaluate the metacarpophalangeal joint function.Complications and fracture healing time were recorded.Results All patients were followed up for a period ranging from 1 to 5 months,with an average duration of(3.45±1.03)months.Among the 98 patients,anatomical alignment was achieved in 75 patients,with 68 patients still maintaining anatomical alignment after fixation removal.Functional alignment was achieved in 23 patients,with 20 patients maintaining functional alignment even after fixation removal.There were 10 patients with displacement after reduction.The average fracture healing time was(5.78±1.14)weeks,and the fracture healed well without any angular or rotational deformities.TAM score was utilized to assess the hand function of patients 3 months post-treatment.The extension range of motion(10.72±1.35)°and flexion range of motion(83.19±4.08)°of the metacarpophalangeal joint were significantly higher than the pre-treatment values of(8.25±0.68)°and(70.35±2.36)°,respectively.These differences were statistically significant(P<0.05).TAM outcomes were excellent in 92 cases,good in 5,fair in 1,and poor in none.Conclusion The implementation of self-made anatomical tower-shaped pad combined with splint plaster fixation is effective for the conservative management of unstable 2nd to 5th metacarpal fractures.
作者
吴小宝
郑晓蓉
王振盛
林志强
WU Xiao-bao;ZHENG Xiao-rong;WANG Zhen-sheng;LIN Zhi-qiang(Department of Orthopaedics,Quanzhou Orthopaedics-Traumatological Hospital,Quanzhou 362000,Fujian,China)
出处
《中国骨伤》
2025年第7期747-751,共5页
China Journal of Orthopaedics and Traumatology
关键词
掌骨骨折
塔形垫
夹板石膏
治疗
Metacarpal fracture
Tower-shaped pad
Sandwich gypsum
Treatment
