Department of Ultrasound, Luoyang Orthopedic-Traumatological Hospital, Luoyang, China.
Hand Microsurgery Unit, Luoyang Orthopedic Hospital of Henan Province (Orthopedic Hospital of Henan Province), Luoyang, China.
J Ultrasound Med. 2019 Oct;38(10):2659-2666. doi: 10.1002/jum.14967. Epub 2019 Feb 21.
To investigate the value of ultrasound-guided closed reduction and minimally invasive fixation in the treatment of metacarpal fractures.
Twenty-four patients with acute metacarpal fractures were randomly divided into experimental and control groups, with 12 patients in each group. Ultrasound-guided closed reduction and fixation were performed in the experimental group, whereas C-arm fluoroscopy-assisted fixation was performed in the control group. Patients in both groups were followed to compare the treatment efficacy.
The success rates of ultrasound-guided closed reduction of fractures were 75.00% (9 of 12) in the experimental group and 83.33% (10 of 12) in the control group, and the difference was not statistically significant (χ = 0.253; P = .615) between the groups. The mean numbers of C-arm fluoroscopy-assisted procedures ± SD were 1.50 ± 0.67 times in the experimental group and 2.50 ± 0.80 in the control group, and the difference was statistically significant (t = -3.317; P = .003). The mean healing times of fractures were 5.47 ± 0.67 weeks in the experimental group and 5.73 ± 0.81 weeks in the control group; the excellence rates of total active motion were 83.33% (10 of 12) in the experimental group and 91.67% (11 of 12) in the control group; the mean grip strength values were 31.78 ± 3.13 kg in the experimental group and 33.43 ± 3.30 kg in the control group. There were no significant differences in those 3 parameters between the groups (P > .05 in each comparison).
Ultrasound-guided closed reduction and minimally invasive fixation is an effective treatment of metacarpal fractures and can reduce exposure to x-ray radiation.
探讨超声引导下闭合复位微创固定治疗掌骨骨折的价值。
将 24 例急性掌骨骨折患者随机分为实验组和对照组，每组 12 例。实验组行超声引导下闭合复位固定，对照组行 C 臂透视辅助固定。两组患者均进行随访，比较治疗效果。
实验组骨折超声引导复位成功率为 75.00%（9/12），对照组为 83.33%（10/12），组间差异无统计学意义（χ²=0.253，P=0.615）。实验组 C 臂透视辅助操作次数的平均值为 1.50±0.67 次，对照组为 2.50±0.80 次，差异有统计学意义（t=-3.317，P=0.003）。实验组骨折愈合时间的平均值为 5.47±0.67 周，对照组为 5.73±0.81 周；实验组总主动活动度优良率为 83.33%（10/12），对照组为 91.67%（11/12）；实验组握力值的平均值为 31.78±3.13kg，对照组为 33.43±3.30kg。3 项参数组间差异均无统计学意义（P>0.05）。
超声引导下闭合复位微创固定是治疗掌骨骨折的有效方法，可减少 X 射线辐射暴露。
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