Comparison of the clinical curative effect between dynamic external fixator and hand orthosis in patients with middle phalanx pars basilaris fracture
10.3760/cma.j.issn.1673-4904.2018.07.017
- VernacularTitle:动力性外固定架和手部支具治疗中节指骨基底部掌侧缘骨折疗效比较
- Author:
Jin ZHOU
1
,
2
;
Deyu ZHENG
Author Information
1. 121000 锦州医科大学基础医学院
2. 大连市普兰店区中心医院手足外科,116200
- Keywords:
Finger phalanges;
Fractures,bone;
External fixators;
Comparative effectiveness research
- From:
Chinese Journal of Postgraduates of Medicine
2018;41(7):646-650
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the clinical curative effect between dynamic external fixator (DEF) and hand orthosis (HO) in patients with middle phalanx pars basilaris fracture. Methods A total of 143 patients with middle phalanx pars basilaris fracture were selected from January 2015 to April 2016. The patients were divided into 2 groups according to the patients′select: DEF group (83 cases) and HO group (60 cases). The patients in DEF group were treated with DEF fixation under local nerve block anesthesia of digital root, and the patients in HO group were treated with HO fixation after manual repositioning. The fracture healing time and complications were observed. All patients were functionally trained and evaluated by total active motion (TAM). Results The patients were followed up for 8 to 16 weeks, with an average of 12 weeks. There was no statistical difference in fracture healing time between 2 groups (P＞0.05). All patients had postoperative pain, but the incidence of postoperative pain after removing DEF or HO in DEF group was significantly lower than that in HO group: 26.51% (22/83) vs. 46.67% (28/60), and there was statistical difference (P＜0.05). No redislocation or subluxation occurred after removal of external fixation in 2 groups. X-ray follow-up showed that the incidences of mild traumatic osteoarthritis, mild angulation deformity and mild lateral instability in DEF group were significantly lower than those in HO group: 6.02% (5/83) vs. 23.33% (14/60), 3.61% (3/83) vs. 33.33% (20/60) and 1.20% (1/83) vs. 26.67% (16/60), and there were statistical differences (P＜0.05). The excellent and good rate of TAM in DEF group was significantly higher than that in HO group: 83.13% (69/83) vs. 63.33% (38/60), and there was statistical difference (χ2=7.25, P＜0.01). Conclusions The clinical curative effect of DEF fixation is better than HO fixation in patients with middle phalanx pars basilaris fracture.
