Bozkurt Orhun Eray, Bezirgan Ugur, Acar Erdinc, Nergizal Osman Talha, Dumlupinar Ebru, Armangil Mehmet
Kulu Devlet Hastanesi, Ortopedi ve Travmatoloji, El Cerrahisi Bölümü, 42777 Kulu, Konya, Türkiye
Jt Dis Relat Surg. 2025 Jan 2;36(1):182-192. doi: 10.52312/jdrs.2025.1983. Epub 2024 Dec 18.
This study aimed to compare the outcomes and conduct a cost analysis between plate screw fixation and conservative treatment.
The retrospective study was conducted with 36 patients (32 males, 4 females; mean age: 30.3±13.4 years; range, 16 to 65 years) between May 2019 and July 2023. The patients were divided into two groups: those who underwent surgery with miniplate fixation (n=21) and those who were conservatively managed (n=15). The differences in postoperative shortening and angulation were compared between these groups. Additionally, the patients' postoperative functional scores, complication rates, examination findings, and cost analyses were compared.
The per-patient cost in the surgical group was higher than in the conservatively treated group (€246.96 vs. €45.07; p<0.001). While postoperative shortening and angulation were more pronounced in the nonoperative group, the other clinical parameters and functional scores were improved. The return-to-work time was longer in the nonoperative group due to prolonged immobilization.
Nonoperative splint treatment for metacarpal shaft fractures shows better radiological and clinical outcomes than surgery, except for angulation and shortening, which have limited impact on function. Due to higher costs in surgical cases, nonoperative treatment is more cost-effective. Larger, randomized trials are needed to confirm these findings.
本研究旨在比较钢板螺钉固定与保守治疗的疗效并进行成本分析。
本回顾性研究纳入了2019年5月至2023年7月期间的36例患者（32例男性，4例女性；平均年龄：30.3±13.4岁；范围16至65岁）。患者被分为两组：接受微型钢板固定手术的患者（n = 21）和接受保守治疗的患者（n = 15）。比较两组术后短缩和成角的差异。此外，还比较了患者的术后功能评分、并发症发生率、检查结果和成本分析。
手术组的人均成本高于保守治疗组（246.96欧元对45.07欧元；p < 0.001）。虽然非手术组术后短缩和成角更明显，但其他临床参数和功能评分有所改善。由于固定时间延长，非手术组的重返工作时间更长。
除了成角和短缩对功能影响有限外，掌骨干骨折的非手术夹板治疗在影像学和临床疗效方面优于手术治疗。由于手术病例成本较高，非手术治疗更具成本效益。需要更大规模的随机试验来证实这些发现。
