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巴黎石膏管型与尺侧沟夹板在第五掌骨骨折保守治疗中的功能及影像学结果比较

A comparison of the functional and radiological results of Paris plaster cast and ulnar gutter splint in the conservative treatment of fractures of the fifth metacarpal.

作者信息

Gulabi Deniz, Avci Cem Coskun, Cecen Gultekin Sıtkı, Bekler Halil Ibrahim, Saglam Fevzi, Merih Erdogan

机构信息

Dr. Lütfi Kırdar Kartal Training and Research Hospital, Semsi Denizer Cad. E5. Yanyol Cevizli Kavsagı Kartal, 34890, Istanbul, Turkey,

出版信息

Eur J Orthop Surg Traumatol. 2014 Oct;24(7):1167-73. doi: 10.1007/s00590-013-1290-2. Epub 2013 Aug 10.

Abstract

AIM

In the treatment protocol of fractures of the fifth metacarpal, closed reduction and immobilization is generally recommended. This study aimed to compare the radiological and functional results of short-arm plaster cast and a forearm U-splint.

PATIENTS AND METHODS

Between January 2011 and June 2012, the study comprised a total of 122 cases with 64 (52.4%) in the cast group and 58 (47.6%) in the splint group. The cases were 92 (75.4%) males and 30 (24.6%) females with a mean age of 30.56 ± 12.27 years (range 10-66 years). Two groups were formed according to the surgical treatment plans of the two surgeons who were to follow up the patients.

RESULTS

No statistically significant difference was found between the groups in terms of age, duration of the cast or splint and follow-up period (p > 0.05). The grip strength of Group A was determined as 90.38 ± 1.77% of the healthy side and Group B as 90.58 ± 1.65%. No statistically significant difference was seen between the groups in respect of grip strength (p > 0.05). The degree of dorsal angulation pre-application, post-application and after removal of the groups showed no statistically significant difference between the groups (p > 0.05).

CONCLUSION

No superiority was seen in the clinical and radiological results of the two different treatment protocols applied to fractures of the fifth metacarpal. However, when the complications created by a plaster cast and pressure wounds are taken into consideration, the application of a short-arm U-splint can be said to be a better option.

摘要

目的

在第五掌骨骨折的治疗方案中,一般建议采用闭合复位和固定。本研究旨在比较短臂石膏管型和前臂U型夹板的放射学和功能结果。

患者与方法

2011年1月至2012年6月,本研究共纳入122例患者,其中石膏管型组64例(52.4%),夹板组58例(47.6%)。患者中男性92例(75.4%),女性30例(24.6%),平均年龄30.56±12.27岁(范围10 - 66岁)。根据两位负责随访患者的外科医生的手术治疗计划形成两组。

结果

两组在年龄、石膏管型或夹板使用时长以及随访时间方面无统计学显著差异(p>0.05)。A组握力测定为健侧的90.38±1.77%,B组为90.58±1.65%。两组在握力方面无统计学显著差异(p>0.05)。两组在应用前、应用后及去除后的背侧成角程度在组间无统计学显著差异(p>0.05)。

结论

应用于第五掌骨骨折的两种不同治疗方案在临床和放射学结果方面未见优势。然而,考虑到石膏管型造成的并发症和压疮,应用短臂U型夹板可说是更好的选择。

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