改良Iselin 术与切开复位内固定术治疗 Bennett 骨折的对比研究

Comparative study of modified Iselin and open reduction with internal fixation for Bennett’s fracture

摘要:

目的 比较改良Iselin 术与切开复位内固定术治疗Bennett 骨折的临床疗效。方法 选取2015 年 1 月—2018 年12 月在新疆生产建设兵团医院接受手术治疗的36 例Bennett 骨折患者。其中接受改良Iselin 术 患者19 例（实验组），接受切开复位内固定术患者17 例（对照组），比较两组患者术后疗效。结果 所有患 者获得随访，参照Kjaer-Petersen 标准对术后复位情况进行评估。两组患者术后第1 天、第6 周复位情况比较， 差异无统计学意义（P >0.05）。参照中华医学会手外科学术会上肢部分功能评定试用标准对腕掌关节功能进 行评价，两组患者术后第1 天、第6 周功能情况比较，差异无统计学意义（P >0.05）。两组患者术后第6 周复 查时各出现1 例骨折再移位患者，再次处理后临床愈合。结论 改良Iselin 固定术适用广泛，包括关节内和关 节外的第一掌骨基底部骨折。改良Iselin 固定术优点众多，包括耗时短、微创、经济、固定牢靠及辐射量少， 免除2 次手术等优点，具有临床推广价值。

Abstract:

Objective To compared the clinical efficacy between modified Iselin and open reduction with internal fixation for Bennett fractures. Methods Thirty-six patients with Bennett fractures who underwent surgery in Xinjiang Production and Construction Corps Hospital from January 2015 to December 2018, including 19 patients with modified Iselin (experiment group) and 17 patients with open reduction and internal fixation (control group). The efficacy of the two groups was compared. Results All patients were followed up. The postoperative reduction was evaluated according to the Kjaer-Petersen criteria. The two groups were compared 1st day and 6 weeks after surgery (P>0.05). There was no significant difference in the function of the carpometacarpal joint between two groups 1st day and 6 weeks after surgery, according to the trial criteria of upper limb function evaluation of the Chinese Medical Association Hand Surgery Academic Society (P>0.05). One patient with fracture relocation occurred in each group at 6 weeks of reexamination, and healed after retreatment. Conclusions In summary, our modified Iselin fixation is widely used, including the first metacarpal base fracture in and out of the joint. Modified Iselin fixation has many advantages, including short time-consuming, minimally invasive, economical, fixed and reliable, less radiation, and free of secondary surgery. It has good clinical promotion value.