本文選題：可吸收棒　切入點：微型接骨板　出處：《山西醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:比較可吸收棒與微型接骨板治療掌骨斜形骨折的臨床療效。方法:總共80例95處掌骨斜形骨折的患者,分為可吸收棒內固定組(A組,29例31處)和微型接骨板內固定組(B組,51例64處)。所有病例均為閉合性掌骨斜形骨折患者,無明顯手術禁忌,排除病理性骨折及炎癥、感染或對植入材料過敏的病人。全部患者都在臂叢麻醉及止血帶下手術。分別采取微型接骨板和可吸收棒內固定治療。要求術中骨折斷端達到解剖復位,經C臂透視下觀察復位滿意,然后沖洗創(chuàng)面并逐層縫合切口。手術過程中注意保護腱周組織,減輕術后肌腱粘連,術后隨訪時間為1~12個月(平均6.5個月)。對術后手功能恢復評價標準,我們采納美國手外科協(xié)會評分(TAFS)標準。記錄指間關節(jié)以及掌指關節(jié)活動度,兩組記錄所得數據結果進行統(tǒng)計學分析處理采用SPSS19.0軟件,計數資料采取χ2檢驗,計量資料采取t檢驗。結果:所有骨折均達到骨性愈合。術后都未出現內固定物松動、感染及皮膚過敏等情況,兩組所納入病例也未出現掌骨骨折延遲愈合或不愈合情況。按照美國手外科協(xié)會評分標準,微型鋼板51例(64處)骨折中,優(yōu)31處,良25處,差8處,優(yōu)良率87.5%;可吸收棒組29例(31處)骨折中,優(yōu)19處,良11處,差1處,優(yōu)良率96.7%,兩組間優(yōu)良率無顯著差異(P0.05)。結論:可吸收棒固定強度能達到手術治療要求,治療掌骨斜形骨折操作方便簡單,無異物感及應力遮擋,避免再次手術,無影像干擾,組織相容性好,是一種理想并且有效的治療方法。
[Abstract]:Objective: to compare the clinical efficacy of absorbable rod and microplate in the treatment of oblique metacarpal fractures. They were divided into absorbable rod fixation group (n = 29, n = 31) and microplate fixation group (n = 51, n = 64). All cases were closed oblique metacarpal fractures. All patients were operated under brachial plexus anesthesia and tourniquet. Microplate and absorbable rod fixation were performed respectively. Satisfactory reduction was observed by C-arm fluoroscopy, then wound was flushed and wound was sutured layer by layer. Attention was paid to the protection of peritendinous tissue during operation, and to the reduction of tendon adhesion after operation. The follow-up time was 1 ~ 12 months (mean 6.5 months). For the evaluation criteria of postoperative hand function recovery, we adopted the TAFS standard to record the movement of interphalangeal and metacarpophalangeal joints, and recorded the movement of interphalangeal joints and metacarpophalangeal joints. The data of the two groups were analyzed statistically by SPSS19.0 software. The count data were analyzed by 蠂 2 test and the measurement data by t test. Results: all the fractures were bony healed. No internal fixation loosening was found after operation. Infection and skin allergy were not found in the two groups. According to the American Society of hand surgery (AHSA) scoring standard, 64 cases of mini-plate fractures were excellent in 31 cases, good in 25 cases, and poor in 8 cases. The excellent and good rate was 87.5%, the absorbable rod group was 29 cases with 31 fractures, excellent 19, good 11, poor 1, excellent and good rate 96.77.There was no significant difference in excellent and good rate between the two groups (P 0.05). Conclusion: the strength of absorbable rod fixation can meet the requirement of surgical treatment. The treatment of oblique fracture of metacarpal bone is an ideal and effective method for treatment of oblique fracture of metacarpal with simple operation, no foreign body sensation and stress occlusion, no reoperation, no image interference and good histocompatibility.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.3

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本文編號：1569558